Conclusions
In conclusion, intrauterine growth restriction can occur both in the
context of pre-existing chronic hypertension and in the context of
severe preeclampsia. In principle, preeclampsia is so frequently
associated with intrauterine growth restriction that the latter has
traditionally been included as a feature of preeclampsia, regardless any
additional diagnostic criteria. During the study, it was shown that
preeclampsia is the main condition that leads to the most severe cases
of intrauterine growth restriction. Immediate neonatal adaptation of
preterm neonate small for gestational age is more deficient (indicated
by lower Apgar index values) than for preterm neonates with appropriate
weight for gestational age; the adaptation of preterm neonates, in turn,
is more deficient than term newborns with intrauterine growth
restriction. The term newborns with intrauterine growth restriction have
a neonatal adaptation comparable to that of the term newborns with
weight corresponding to the gestational age. Birth by caesarean section
had an increased incidence both in the cases of premature newborns with
weight corresponding to the gestational age and in the cases with
premature or term growth restriction. Gestational hypertension is a
major risk factor for intrauterine growth restriction without a
statistically significant difference between premature and term births.
Preeclampsia, on the other hand, is significantly associated with
prematurity and intrauterine growth restriction and especially in cases
presenting both conditions simultaneously. Fetal malformations are a
determinant factor of growth restriction, but also of prematurity.
After analyzing the neonatal parameters of the3 study groups, which
included premature infants with low weight for gestational age, preterm
infants with weight corresponding to the gestational age and term
newborns with low weight for gestational age, we can conclude that the
growth restriction superimposed on prematurity is associated the most
unfavorable prognosis among all the parameters.