“Postnatal Growth of Intrauterine Growth Restricted Newborns”

Abstract

Introduction: Intrauterine growth restriction plays a significant role in short and long term adverse outcome. It is reflected in the relatively high incidence of neurodevelopmental impairment and somatic growth failure. Growth in the first year of life gets an opportunity to recover its growth deficit of intrauterine life and to catch up with its normal birth weight siblings Objective of the Study: To assess the postnatal growth of intrauterine growth restricted newborns at 3, 6 and 9 months of age. Methodology: A Prognostic cohort study was conducted at Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh from 1st April 2017 to 20th September 2018. It involved monitoring of 31 intrauterine growth restricted newborns and 39 normal birth weight neonates over a period of 9 months. Follow up were done at 3, 6 and 9 month of age. At every visit weight, length, occipitofrontal circumference and chest circumference were measured. Data was analyzed using SPSS 20 and plotted in tables and graphs. Data imputation was done for the missing data. Multiple regression analysis was done for confounder of growth when data was statistically significant. Results: Mean birth weight were 1748 ±437.09 g and 2893.54±467.07g, birth length 44 ±4.2439 cm and 49.26±1.634cm, birth occipitofrontal circumference 30.76 ±2.380 cm and 34.35±1.083cm, birth chest circumference 24.39 ±1.940 cm and 29.15±2.933cm in IUGR and control group respectively which was statistically significant. There were catch-up weight gain in 3, 6 and 9 months of age in IUGR group but it was less than the normal birth weight group during the followed-up period. During the follow-up period, cacth up growth in length achieved in first 9 months of age. During the first 3 months there were no catch up growth in IUGR babies head circumference but it increases in normal rates. Mean chest circumference values at 3 months were statistically significant and after multiple regression analysis, it is significant for birth length. In general, IUGR babies when compared with the control group remained small in all the four growth parameters but it had catch up growth in first 9 months of age. Conclusion: During the follow-up period, catch-up of growth achieved regarding weight, length, OFC and chest circumference but the growth parameters were lower than the appropriate for gestational age birth weight newborns