Publication:

Study on clinical profile, risk factors, morbidity and mortality pattern on intrauterine growth restricted babies admitted in sick newborn care unit in tertiary care hospital GRMCH, Ramanathapuram

Background Intrauterine growth restriction (IUGR) is an important cause of neonatal morbidity and mortality. Infants with impaired foetal growth often develop metabolic, respiratory and haematological complications during the early neonatal period. Early recognition of risk factors and clinical patterns helps improve neonatal care and outcomes. The present study aimed to assess the clinical profile of IUGR babies admitted to the sick neonatal care unit and evaluate their outcomes during their hospitalization.

Methods A descriptive cross-sectional study was conducted in the Sick Neonatal Care Unit of Government Ramanathapuram Medical College and Hospital, Ramanathapuram. A total of 119 neonates diagnosed with IUGR and admitted during the study period were included and evaluated using clinical examination, anthropometric measurements and laboratory investigations.

Results Most neonates were male 67 (56.3%), with term births 88 (73.9%) and birth weight >2 kg in 71 (59.7%). Asymmetrical IUGR predominated 89 (74.8%). Hypoglycaemia was most frequent 62 (52.1%), followed by sepsis 37 (26.9%), perinatal depression 33 (27.7%) and hypothermia 31 (26.1%). Other complications included thrombocytopenia 27 (22.7%), hyperbilirubinemia 25 (21.1%), hypocalcaemia 24 (20.2%) and acute kidney injury 22 (18.5%). Mortality occurred in 17 (14.3%). Hyperglycaemia was associated with birth weight (p<0.0001), polycythaemia with ponderal index (p=0.012), respiratory distress syndrome with birth weight and gestational age (p<0.0001), pulmonary haemorrhage with gestational age (p=0.005), acute kidney injury with birth weight and gestational age (p=0.008, p=0.005) and sepsis with birth weight and gestational age (p=0.01, p=0.008). Other variables showed no significant association.

Conclusions IUGR remains an important contributor to neonatal morbidity, particularly due to metabolic and infectious complications. Careful antenatal surveillance and early neonatal monitoring are essential for timely management and improved outcomes.