Maternal socio-demographic determinants and fetal outcome of intrauterine growth restriction


  • Arpita Singh Department of Obstetrics and Gynecology, Government Medical College, Thrissur, Kerala, India
  • Ambujam K. Department of Obstetrics and Gynecology, Government Medical College, Thrissur, Kerala, India



Intra uterine growth restriction, Risk factors, small for gestational age


Background: Intrauterine Growth Restriction is a major neonatal health issue. It is associated with increased risk of perinatal morbidity and mortality. Maternal factors are the major contributing factors of IUGR and studying these factors can help in preventing IUGR and reducing perinatal mortality. The objective is to study the maternal sociodemographic risk factors associated with Intra uterine growth restriction.

Methods: This is a Case-control study conducted in the Department of Obstetrics and Gynaecology, GMC Thrissur. 115 cases of Intra Uterine Growth Restriction were compared to 115 controls. Data was collected by interviewing the mother using structured questionnaire which is pretested and by persual of antenatal records. Intra Uterine Growth Restriction is defined as occurring if the sonographic estimated fetal weight <10th percentile for that gestational age. Chi Square test was used for the analysis of data.

Results: Low socio-economic status and malnutrition (BMI<18.5) were significant socio-demographic factors associated with fetal growth restriction. Mean birth weight in IUGR group was 1.8kg compared to 2.9kg in control group. Female fetuses were more commonly associated with IUGR. Intra Uterine Growth Restricted babies had lower Apgar scores (<7) and had more chances for NICU admission.

Conclusions: By studying the maternal risk factors associated with Intra Uterine Growth Restriction, we could identify the high-risk group. Early predictive studies could be done in these high-risk pregnancies with focus on good antenatal care to reduce the problem of IUGR in the community.


Kleijer ME, Dekker GA, Heard AR. Risk factors for intrauterine growth restriction in a socio-economically disadvantaged region. J Maternal-Fetal Neonat Medi. 2005;18(1):23-30.

Fetal growth disorders. In Williams Obstetrics. 24th ed. New York, NY: Mc Graw Hill; 2013:872-890.

Ott WJ. The diagnosis of altered fetal growth. Obstet Gynecol Clinic North Am. 1988;15(2):237-63.

Wilcox AJ. Intrauterine growth retardation: beyond birthweight criteria. Early Hum Dev. 1983;8(3-4):189-93.

Figueras F, Gratacos E. Update on the Diagnosis and Classification of Fetal Growth Restriction and proposal of a Stage-Based Management Protocol. Fetal Diagn Ther. 2014;36(2):86-98.

Fernando Arias, Shirish N Daftary, Amarnath G Bhide. Fetal Growth Restriction. In Practical Guide to High Risk Pregnancy and Delivery-A South Asian Prespective. 3rd ed. Elsevier; 2008:105-34.

Vandenbosche RC, Kirchner JT. Intrauterine growth retardation. Am Fam Physician. 1998;58:1384-94.

Chauhan SP, Taylor M, Shields D, Parker D, Scardo JA, Magann EF. Intrauterine growth restriction and oligohydramnios among high-risk patients. Am J Perinatol. 2007;24(4):215-21.

Motghare DD, Frederick SV, Pawaskar M, Kulkarni MS. Maternal determinants of intrauterine growth restriction in Goa, India: a case-control study. Global J Medic Public Health. 2014;3(1):O8.

Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin WHO.1987;65(5):663-737.

Godfrey K, Robinson S, Barker DJ, Osmond C, Cox V. Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ. 1996;312(7028):410-4.

Rondo PHC, Abbott R, Rodrigues LC, Tomkins AM. The influence of maternal nutritional factors on intrauterine growth retardation in Brazil. Paediatr Perinat Epidemiol. 1997;11(2):152-66.

Isaksson R, Gissler M, Tiitinen A. Obstetric outcome among women with unexplained infertility after IVF: a matched case- control study. Hum Reprod. 2002;17(7):1755-61.

Sehested LT, Pedersen. Prognosis and risk factors for intrauterine growth retardation. Dan Med J. 2014;61(4):A4826.

Spinillo A, Capuzzo E, Nicola S, Colonna L, Lasci A, Zara C. Interaction between fetal gender and risk factors for fetal growth retardation. Am J Obstet Gynecol. 1994;171(5):1273-7.






Original Research Articles