Intrauterine growth restriction and its associated factors in South Gondar zone hospitals, Northwest Ethiopia, 2019

Abstract

Background After prematurity, intrauterine growth restriction (IUGR) is the second leading cause of perinatal mortality. IUGR has significant consequences in fetal, neonatal, and adult life. Currently, Ethiopia lacks information on IUGR’s prevalence and its determinants. This study aimed to assess the proportion of IUGR at birth and its associated factors. Methods A cross-sectional study was carried out among women who give birth in four hospitals of south Gonder zone from November 2018 to February 2019. Multi-stage sampling was applied to select the required samples. IUGR was assessed using a standardized cutoff percentile/mean for each measurement. Data were collected by trained MSc clinical midwives. Bi-variable and multivariable logistic analyses were deployed to identify the association. Results A total of 803 maternity women were participating in this study with a response rate of 95%. The proportion of IUGR 23.5% (95% CI: 20.7–26.6), low birth weight 13.3%, small-for- gestational-age 19.7%,and preterm birth 23.16%. Women who was unable to read and write, (AOR; 2.46, 95% CI: 1.02–5.92), total family size ≥7 (AOR; 1.67, 95% CI: 1.04–2.66), maternal mid-upper arm circumference (MUAC) < 23 cm (AOR; 2.10, 95% CI: 1.39–3.01), body mass index (BMI) < 18.5 kg/m2 (AOR; 2.57, 95% CI: 1.72–3.83), altitude > 3000 m (AOR; 1.89 95% CI: 1.19–3.01), small placental size (< 350 g) (AOR; 2.42, 95% CI: 1.67–3.54) and small-for-gestational-age (AOR; 1.94, 95% CI:1.86–4.52) were the most predictors of IUGR. Conclusions IUGR was a major public health concern in this study. Women who were unable to read and write, small-for-gestational-age, maternal BMI < 18.5 kg/m2, family size ≥7, maternal MUAC < 23 cm, small placental size, and altitude > 3000 m were found the most predictor variables. Strengthen female education, nutritional intervention before and during pregnancy, and routine maternity care is critical. Further clinical follow-up research is essential which includes maternal, fetal, and placental gens.

Prevalence and Risk Factors of Preterm Birth Among Pregnant Women Admitted at the Labor Ward of the Komfo Anokye Teaching Hospital, Ghana

“…The present study observed that participants who had IUGR were 2-fold increased odds of preterm birth. The finding is consistent with a cross-sectional study conducted in Ethiopia by Tesfa et al ( 18 ). The mechanism, which underpins this finding could be attributed to uteroplacental under perfusion that might have resulted in growth restriction of the fetus ( 18 ).…”

Fetal Malnutrition and Associated Factors among Term Newborn Babies at Birth in South Gondar Zone Hospitals, Northwest Ethiopia

“…This study was carried out among the four hospitals of the South Gondar zone (Debre Tabor, Nefas-Mewicha, Mekane Eyesus, and Addis Zemene). South Gondar is a zone in Ethiopian Amhara region [ 22 ]. In Ethiopia, even though there is a substantial increment in institutional delivery from 5% in 2005 to 48% in 2019, still greater than half (52%) of the women have delivered at home [ 23 ].…”

“…To ensure the quality of data, training was given for all data collectors at each hospital for one day on the overall procedure of data collection by the principal investigator and pediatricians supported with video [ 22 ]. The questionnaire was pretested before the actual data collection time on 5% of the sample.…”

The Price of Surviving on Adrenaline: Developmental Programming Responses to Chronic Fetal Hypercatecholaminemia Contribute to Poor Muscle Growth Capacity and Metabolic Dysfunction in IUGR-Born Offspring

“…Their dogma-establishing discovery, which they termed the Thrifty Phenotype Hypothesis, has been substantiated by thorough subsequent research that collectively estimates IUGR-born individuals to be at 18-fold greater risk for developing clinical metabolic disease by adulthood (reviewed in detail by Crispi et al, 2017 ; Yates et al, 2018 ). IUGR affects up to 25% of pregnancies worldwide and is the 2nd leading cause of perinatal mortality and morbidity ( Wu et al, 2006 ; Hoyert and Gregory, 2020 ; Tesfa et al, 2020 ). Moreover, the impact of IUGR on the health of surviving offspring can manifest as early as 3 years of age ( Iniguez et al, 2006 ; Milovanovic et al, 2014 ).…”