Risk factors for intrauterine growth restriction among women delivering at Mulago National and Naguru Regional Referral Hospitals: A case-control study

Abstract

Introduction: Intrauterine growth restriction (IUGR) is an important cause of perinatal morbidity and mortality with long term health implications for the survivors. It affects approximately 30 million newborns per year worldwide, with a nationwide prevalence of 10% as per Uganda Bureau of Statistics (2011). It’s associated with both early neonatal and late adult consequences. Early diagnosis and intervention in women at high risk during antenatal, can help improve maternal and perinatal outcome. Objective: The objective of the study was to determine the risk factors for intrauterine growth restriction among women delivering at Mulago National and Naguru Regional Referral Hospitals between December 2017 and June 2018. Materials and Methods: This was a case control study. Cases were mothers whose babies were term (37 - 42) weeks with birth weight < 2.5kg. Controls were mothers whose babies were term with birth weight ≥ 2.5kg. A ratio of 1:1 was used. A total of 129 cases were compared to 129 controls during the study period. Participants were recruited after delivery. Antenatal record and dating ultrasound scans were scrutinized as sources data. Interviewer administered questionnaire was also used for data collection. Data was analyzed using STATA version 13.0. Pearson Chi-square test, odds ratio with 95%CI and multiple logistic regression were done for bivariate and multivariate analysis respectively. Results: Hypertensive disorders, maternal nutrition and delivering a baby girl were found to be significant risk factors for intrauterine growth restriction. The odds of IUGR with hypertensive disorders were 3.22, 95% CI (1.06, 9.74) p-value = 0.039. Being overweight and obese were found to be protective with [OR= 0.41, 95% CI (0.24, 0.72) p-value = 0.002 and [OR=0.38, 95% CI (0.17, 0.85)] p-value = 0.019 respectively. The odds of an IUGR baby girl were almost 2-fold that of a boy [OR=1.99, 95% CI (1.18, 3.35)] Conclusion: Being hypertensive and delivering a baby girl was significantly associated with intrauterine growth restriction, while obesity and overweight mothers were less likely to give birth to babies with intrauterine growth restriction.