Comparative Analysis of Normal versus Fetal Growth Restriction in Pregnancy: The Significance of Maternal Body Mass Index, Nutritional Status, Anemia, and Ultrasonography Screening
Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. The objective of this study was twofold: first to examine the correlation between maternal parameters such as body mass index (BMI), nutritional status, anemia, and placental weight and diameter, and their effects on fetal growth and then to evaluate the effect of early screening by ultrasonography (USG) on the outcome of growth restricted pregnancies. In this study, 53 cases of fetal growth restriction were compared to 53 normal fetuses delivered in consecutive sequence. Growth restricted fetuses were delivered earlier in gestation, when compared with normal growth fetuses. Maternal anemia and malnutrition have significant association with the fetal growth restriction. Maternal anthropometry, such as low BMI, had effects on placental diameter and weight, which, in turn, adversely affected fetal weight. Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction. 1. Introduction In this century, fetal growth restriction continues to be a significant perinatal problem [1]. A growth restricted fetus is one with an estimated fetal weight of less than the tenth percentile for that gestational age [2]. The prevalence of growth restricted fetuses is known to be about 10% [3]. The incidence of fetal growth restriction varies depending upon the population residing in the developing and developed countries with a incidence rate of 6–30% to 2–5% in these countries, respectively [4, 5]. The highest rate of prevalence of fetal growth restriction is found in Asia, particularly in Southeast Asia, followed by Africa and Latin America [6, 7]. These statistics make the fetal growth restriction during pregnancy a major public health concern throughout the world, especially in the developing countries with a huge population base, a lack of good and affordable health care infrastructure, and a low patient-physician ratio. Fetal growth restriction or intrauterine growth restriction (IUGR) cannot be termed into a specific disease entity per se, but it is rather a complex multi-factorial condition. It is manifested as a result of several fetal and maternal disorders [2]. The factors affecting fetal growth restriction are the nature of the
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