Clinical Profile and Neonatal Outcomes of Pregnancies Complicated By Intrauterine Growth Restriction: Correlation of Antenatal Findings with Birth Weight, Doppler Parameters, and Early Neonatal Outcomes

Abstract

Background: Intrauterine growth restriction (IUGR) is an important cause of perinatal morbidity and mortality. Antenatal ultrasonography and fetal Doppler assessment help identify pregnancies at increased risk of adverse neonatal outcomes. This study evaluated the clinical profile and neonatal outcomes of pregnancies complicated by IUGR and examined the relationship between antenatal findings, Doppler parameters, birth weight, and early neonatal outcomes.

Methods: A hospital-based observational study was conducted in the Department of Obstetrics and Gynecology, KLE JGMMMC, Hubballi, Karnataka, over a period of six months. A total of 100 pregnancies complicated by IUGR were included. Maternal and obstetric characteristics, antenatal fetal biometry, estimated fetal weight (EFW), umbilical artery Doppler parameters including pulsatility index (PI), resistance index (RI), and systolic/diastolic (S/D) ratio, gestational age at delivery, mode of delivery, neonatal birth weight, Apgar scores, NICU admission, and early neonatal complications were assessed. Associations and correlations between antenatal findings and neonatal outcomes were evaluated using appropriate statistical tests.

Results: The most common maternal age group was 25–29 years (36%), and 54% were primigravidas. IUGR was most frequently diagnosed at 33–36 weeks (42%). Reduced fetal abdominal circumference was observed in 68% of cases and oligohydramnios in 32%. Normal umbilical artery Doppler findings were present in 62%, while 38% had abnormal Doppler findings. Caesarean delivery occurred in 68% of cases. The most frequent birth-weight category was 2000–2499 g (44%). Apgar score ≥7 was observed in 72% at 1 minute and 88% at 5 minutes. NICU admission occurred in 46% of neonates. EFW showed a strong positive correlation with birth weight (r=0.82, p<0.001). Abnormal Doppler findings were associated with lower mean birth weight (1705 ± 430 g vs. 2100 ± 410 g, p<0.001) and higher NICU admission (73.7% vs. 29.0%, p<0.001). Umbilical artery PI, RI, and S/D ratio showed significant inverse correlations with birth weight.

Conclusion: Pregnancies complicated by IUGR demonstrated substantial preterm delivery and early neonatal morbidity. Antenatal fetal biometry and umbilical artery Doppler assessment were associated with neonatal birth weight and NICU admission. Integration of fetal growth assessment with Doppler surveillance may assist in identifying pregnancies at increased risk of adverse neonatal outcomes and support timely obstetric management.