Serum Lipid Profile in Newborns with Intrauterine Growth Retardation and Its Comparison with Appropriate for Gestation Age Newborns

Background: Newborns with intrauterine growth retardation (IUGR) are known to permanently change their physiology and metabolism to adapt to limited supply of nutrients in utero. These programmed changes can later be the cause for the origin of diseases like coronary artery disease, diabetes mellitus and hypertension. If the premature development of cardiovascular risk factors can be anticipated during childhood, future events can be prevented effectively by taking appropriate measures.

Objective of the Study: To study serum lipid profile of newborns with IUGR and Appropriate for Gestation Age(AGA) newborns and compare them.

Methodology: This cross sectional study was conducted from February 2018 to September 2018 in the department of Neonatology, BSMMU, Dhaka, Bangladesh. Newborn who met the inclusion criteria, information regarding antenatal, natal and postnatal history were recorded in a data collection form after taking consent from the parents/guardians. Weight, length, OFC were taken along with other clinical examination. Serum samples of infant with intrauterine growth retardation and matched group of Appropriate for Gestation Age newborns were collected within 24 hours of postnatal age before starting feed and sent to Biochemistry laboratory of BSMMU and analyzed for lipid profile which included serum cholesterol, Triglyceride, Low Density Lipoprotein(LDL) and High Density Lipoprotein (HDL).All data were recorded in a preformed questionnaire and data was analyzed by statistical package for social sciences (SPSS) version 20. Quantitative data were expressed as mean SD and categorical data were presented as proportion. All quantitative variables were compared by unpairedt-test; categorical variables were compared by Chi-square test or Fisher’s exact test. P < 0.05 was considered as significant. Pearson correlation was done to see the correlation between gestation age and lipid profile in both IUGR and AGA newborns.

Results: Total population included 43 IUGR newborns and 43 AGA newborns who were matched by gestational age and sex. No significant difference was seen among both the groups based on demography except for birth weight which was lower in IUGR newborns than AGA newborns (1398.02 307.14 vs 1777.91 551.2 , p=<0.001). It was observed that serum triglyceride level in IUGR group was significantly higher than those in AGA group (90.23 48.16 vs. 70.13 27.76, p=0.020). Serum HDL-c level was found to be significantly lower in IUGR group as compared to AGA group (20.62 8.88 vs. 26.95 7.91, p=0.001). There was a significant negative correlation between gestation age and serum LDL-c level in IUGR infants(r = -0.334).

Conclusion: As compared to AGA newborns, IUGR infants had significantly higher levels of triglyceride and lower levels of HDL-c. Significant negative correlation was observed between gestation age LDL-c in IUGR newborns.