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.