Maternal and Placental Risk Factors for Small Gestational Age and Fetal Malnutrition.

Autor:	Natarajan V; Department of Pediatrics and Neonatology, All India Institute of Medical Sciences, Rishikesh, India., Singh P; Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India., Vigneshwar NKV; Department of Pediatrics and Neonatology, All India Institute of Medical Sciences, Rishikesh, India., Anthony ML; Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India., Rao S; Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India., Chacham S; Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India., Chaturvedi J; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, India., Basu S; Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India.
Jazyk:	angličtina
Zdroj:	Current pediatric reviews [Curr Pediatr Rev] 2023; Vol. 19 (2), pp. 187-196.
DOI:	10.2174/1573396318666220705154424
Abstrakt:	Aims: This case-control study was conducted to identify maternal and placental risk factors of small-for-gestational-age (SGA) and fetal malnutrition. Methods: Cases comprised 104 consecutively delivered SGA neonates (determined as per INTERGROWTH- 21st standard). An equal number of next-born gestation and gender-matched appropriatefor- gestational age (AGA) neonates served as controls. Maternal risk factors were enquired, and placentae were evaluated by clinical and histopathological examination. Nutrition of the neonates was assessed by the clinical assessment of nutrition (CAN) score. Univariate and multivariate logistic regression analysis was done to identify the maternal and placental risk factors. Results: The prevalence of SGA in the present study was 23.9%. Maternal fever [adjusted Odds Ratio (aOR), 95% confidence interval (CI), 16.3 (3.5-124.1); p = 0.001], presence of placental syncytial knots [aOR (95% CI), 2.9 (1.1-9.1); p = 0.04] and placental calcifications [aOR (95% CI), 3(1.1- 8.7); p = 0.03], were identified as independent predictors of SGA using multivariate logistic regression analysis. Malnutrition (SCORE <25) affected 64% of SGA and 16.3% of AGA neonates. The only risk factor significantly associated with malnourished SGA was prematurity, whereas malnourished AGA was significantly associated with prematurity and fetal distress. In-hospital morbidities significantly higher in SGA were perinatal asphyxia, respiratory distress, need for respiratory support, polycythemia, hypoglycemia, and feeding intolerance. Mortality before discharge was 4.8% and 3.8% in SGA and AGA population, respectively (p > 0.05). Neonatal outcomes were comparable among well-nourished, malnourished SGA and AGA groups. Conclusion: Maternal fever, placental syncytial knots, and calcifications were independent risk factors of SGA, whereas prematurity and fetal distress were responsible for malnutrition. (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu