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Minerva Pediatrics 2021 October;73(5):426-34

DOI: 10.23736/S2724-5276.17.04965-9


language: English

The impact of intrauterine growth restriction on respiratory outcomes

Bárbara OLIVEIRA 1 , Filipa FLÔR-DE-LIMA 1, 2, Gustavo ROCHA 1, 2, Manuela RODRIGUES 2, Rita LADEIRAS 1, Hercília GUIMARÃES 1, 2

1 Faculty of Medicine, University of Porto, Porto, Portugal; 2 Neonatal Intensive Care Unit, Pediatric Hospital, Hospital of São João, Porto, Portugal

BACKGROUND: Intrauterine growth restriction (IUGR) is caused by fetal growth below what is normal for its genetic potential. Recent studies have shown a distinct association between changes in umbilical artery flow in IUGR subjects and an increased risk of respiratory morbidity and consequently, higher mortality. The aim of this study was to find the impact of IUGR on the respiratory outcomes of premature neonates born with less than 32 weeks gestational age.
METHODS: This retrospective cohort study targeted infants born with less than 32 weeks of gestation, admitted at NCIU, between January 2010 and December 2016. Each selected IUGR case was matched according to gestational age and sex with an appropriate birthweight newborn at a 1:2 ratio, within a 12-month period.
RESULTS: The study involved 126 neonates, 42 with IUGR, and 84 control subjects. IUGR was not identified as a predictor of Bronchopulmonary Dysplasia (BDP) (OR 4.80, 95% CI: 1.14-20.21, P=0.033). Abnormal umbilical artery flow (OR 4.80, 95% CI: 1.14-20.21, P=0.033) and late onset sepsis (OR 3.31, 95% CI: 1.04-10.56, P=0.044) were significantly associated with BDP.
CONCLUSIONS: It is essential to recognize changes in the umbilical artery flow, especially in high-risk pregnancies such as IUGR, since these represent an a priori risk marker for the development of BDP. The individual and combined effect of IUGR, alterations on umbilical artery flow and extreme prematurity has not yet been completely clarified on the impact on lung morbidity, requiring a larger number of studies.

KEY WORDS: Bronchopulmonary dysplasia; Fetal growth retardation; Infant, premature; Risk factors; Umbilical arteries

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