Study of Maternal Risk Factors in Small for Gestational Age (SGA) Babies with Fetal Malnutrition

Abstract

Introduction: Maternal risk factors for fetal malnutrition (FM) included adverse age, primiparity, low pre-pregnancy weight and height, a bad obstetric history and pregnancy induced hypertension. Malnutrition in the newborn might be missed if intrauterine growth curves only are used for assessment. The CAN Score is a simple and rapid clinical scoring system for diagnosing fetal malnutrition in Small for Gestational Age (SGA) babies. Aim: The aim of the study is to assess association of high risk factors in mother like anemia, malnutrition low BMI, pre-eclampsia, multiple pregnancy, maternal age (<18yrs),maternal weight (<40kg) and height, socioeconomic status and prevalence of FM in SGA babies. Subjects and Methods: This is a prospective hospital based study carried out at the Neonatology unit of Tertiary Care Institute in Government Medical College, Nagpur. Baby-Mother pairs who met the inclusion criteria for the study were recruited consecutively. Relevant biodata is recorded and babies nutritional status were assessed using the Clinical Assessment of Nutritional Status Score chart. Data were entered into a Microsoft Excel sheet and analyzed using standard statistical tools. Results: In present study 903 term SGA neonates and mothers, 477(52.8%) (weight <2.5 kg) were males and 426(47.2%) were females. The prevalence of FM in SGA babies is 34.21%. Analysis of maternal risk factors showed maternal age <18 yrs and >30 yrs, BMI <18, Anemia and PIH were associated with high occurrence of FM and statistically significant (P<0.006). Conclusion:The prevalence of FM is high in high risk mothers and highlights the need for evolving appropriate interventions and strategies for its Prevention. Screening Programmes to identify the high risk mothers in early pregnancy so that medical and nutritional interventions can be started early to overcome the damaging effects of these risk factors. These interventions will have great long term impact on improving child survival.