Association of clinico-sonographic factors with neonatal outcome of iugr babies

Objectives: To identify clinico-sonographic factors associated with outcome of IUGR neonates.
Study design: cross-sectional study
Place and Duration of study: Neonatal intensive care (NICU) at Liaquat National Hospital, Karachi. January 2015 to December 2015.
Methodology: After Ethical committee approval was obtained. A total of 70 IUGR babies were enrolled in the study. Data analysis was done using SPPS version 22. All data with significant p-values (<0.05) were then analyzed with Odd ratio (OR). Pearson chi-square test was applied for sonographic markers associated with mortality.
Results: The mean weight at birth was 1.27 ± 0.30 kg while the mean height and FOC was found to be 37.5 ± 3.91cm and 28.4 ±2.85 cm respectively. Neonates were classified according to gestational age, type of IUGR, birth weight and antenatal ultrasound findings. The most common morbidity found was metabolic derangement followed by RDS, IVH, PPHN and NEC. Risk factor associated IUGR mortality were prematurity [OR 39.42, 95% CI; p= 0.04], symmetrical IUGR [OR 32.5, 95% CI; p= 0.00], weight< 3rd percentile [OR 8.63, 95% CI; p= 0.004] and severe placental insufficiency [OR 39.46, 95% CI; p= 0.00]. There is evidence of strong significant association positive correlation between severe placental insufficiently and mortality (r= 0.750).
Conclusion: IUGR babies with severe placental insufficiency had high mortality and morbidity. Early identification of abnormal placental flow by Doppler study will enable clinicians to initiate surveillance, prompt obstetrical management and to anticipate neonatal outcome.