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

Abstract

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\(\pm\) 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\(\pm\) 307.14   vs  1777.91\(\pm\) 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 \(\pm\) 48.16  vs. 70.13 \(\pm\) 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\(\pm\) 8.88  vs. 26.95 \(\pm\) 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.