EFFECTS OF INTRAUTERINE GROWTH-RETARDATION ON MORTALITY AND MORBIDITYIN INFANTS AND YOUNG-CHILDREN

This review aims to quantify the risks of mortality and morbidity asso ciated with intrauterine growth retardation (IUGR). Twenty-nine data s ets with birth-weight-specific mortalities are examined to determine w hether consistent patterns of risk emerge when data from different pop ulations are compared. Measures of mortality risk are also made with b irth weight as a dichotomous variable. Twelve data sets are presented. From the data available, it is estimated that for term infants weighi ng 2000-2499 g at birth, the risk of neonatal death is 4 times higher than for infants weighing 2500-2999 g, and 10 times higher than for in fants weighing 3000-3499 g. The risk of postneonatal death in term inf ants weighing 2000-2499 g is estimated to be 2 times higher than for i nfants 2500-2999 g, and 4 times that of infants weighing 3000-3499 g. Estimates of risk for IUGR infants are less consistent than for preter m infants. This could be due to methodological differences, particular ly smaller sample sizes in the studies in developing countries, or may reflect real variation in risk. The latter may be associated with the heterogeneity of IUGR across populations, or to varying risks dependi ng, for example, on which infections predominate or infant age at peak prevalence. IUGR is most prevalent in developing countries and the re view therefore focuses on morbidity from diarrhoeal and respiratory in fections. Data from nine studies are presented. There is an increased risk of diarrhoea in term infants <2500 g and an increased risk of pne umonia. The risks of morbidity and mortality appear to differ dependin g on whether infants are wasted or stunted at birth. Stunted infants o f low birth weight have higher neonatal mortality than wasted newborns , but this could be due to inclusion of infants with congenital anomal ies who are often stunted. Wasted infants are more prone than stunted infants to neonatal morbidity. No comparative postneonatal data were l ocated.