ASSOCIATION OF INTRA-UTERINE GROWTH RESTRICTION WITH PREGNANCY INDUCED HYPERTENSION

Abstract

Background: Pregnancy-induced hypertension (PIH) is one of the most common causes of morbidity and mortality among pregnant women and their fetuses internationally. The impaired uteroplacental perfusion in the case of PIH impairs fetal growth causing intrauterine growth restriction (IUGR) that leads to adverse perinatal outcomes. Objective:  To determine the prevalence of intrauterine growth restriction (IUGR) among pregnant women and to assess the association between intrauterine growth restriction and pregnancy-induced hypertension (PIH). Methods: This was a Comparative Cross-sectional study that was carried out Department of obstetrics & Gynecology, Allama Iqbal Teaching Hospital DG Khan, from March 2026 to June 2026. Comprising 146 patients with PIH and 146 normotensive pregnant women. Women aged 20–40 years with singleton pregnancies of 37 weeks gestation or over, but less than 5 parities at time of enrollment were recruited using non-probability consecutive sampling. Standardized antenatal ultrasound scan was performed on a normal timeframe by an experienced radiologist, blinded to the hypertensive status of the mother, to assess fetal growth. Data were collected on demographic and obstetric features, and analyzed using SPSS version 23. The Chi-square test, odds ratios (ORs) with 95% confidence intervals (CIs) and stratified analyses were used to evaluate associations. Results: IUGR was identified in 41.1% (60/146) of women with PIH compared with 8.2% (12/146) of normotensive women (p<0.001). The odds of IUGR were significantly higher for women with PIH (OR 7.85; 95% CI: 3.98–15.48). This association was also observed after stratification for maternal age, parity, obesity and gestational diabetes (p<0.05). The mean birth weight was also significantly lower for neonates born to mothers with PIH than for the control mothers. Conclusions: There is a strong association between intrauterine growth restriction and pregnancy-induced hypertension. However, early detection, careful surveillance and early management of PIH can significantly improve IUGR-related adverse outcomes of the perinatal period. These data call for further large-scale multicenter prospective studies to confirm them.