Frequency of Neonatal Morbidity and Mortality in Intrauterine Growth-Restricted Term Pregnancies in Karachi: A Hospital-Based Cross-Sectional Study

Neonatal Morbidity and Mortality in Intrauterine Growth-Restricted Term Pregnancies

Abstract

Intrauterine growth restriction (IUGR) is a major cause of illness and death in neonates. Growth-restricted term neonates are susceptible to hypoglycemia, respiratory distress, and perinatal mortality. Objective: To determine the frequency of neonatal morbidity and mortality among intrauterine growth-restricted (IUGR) term pregnancies. Methods: A hospital-based cross-sectional study was performed at the Department of Obstetrics and Gynecology, Liaquat National Hospital, Karachi, from June to November 2024. A total of 143 women with singleton term pregnancies (≥ 37 weeks diagnosed with intrauterine growth restriction (IUGR) due to estimated fetal weight below the 10^th percentile were enrolled through consecutive sampling. Neonatal outcomes were documented. Categorical variables were presented as frequency and percentage. A p-value of ≤ 0.005 was deemed statistically significant. Results: The median maternal age was 29 years, with a 30.8% having a history of IUGR and 37.8% experiencing intrauterine death; 53.1% delivered vaginally and 46.9% through a cesarean section. Meconium aspiration occurred on 31.5%, low birth weight in 9.1%, and NICU admission in 35.0%, with hypoglycemia (2.1%) and perinatal mortality (4.9%) being uncommon. Lower maternal age was associated with low birth weight and hypoglycemia, adverse Apgar scores with adverse neonatal outcomes, and increased NICU admission after cesarean delivery. Conclusions: Intrauterine growth-restricted term pregnancies are strongly associated with adverse perinatal outcomes, including respiratory compromise, metabolic instability, and increased risk of mortality.