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Abstract

Intrauterine growth restriction (IUGR) is a significant contributor to perinatal morbidity and mortality in low- and middle-income countries. Objectives: To determine maternal and clinical risk factors for IUGR among pregnant women at a tertiary care hospital in Karachi. Methods: This case-control study was conducted in the Department of Obstetrics and Gynecology, Kharadar General Hospital, from November 2023 to April 2024. A total of 188 women were enrolled, including 94 cases (women with IUGR) and 94 controls (women without IUGR). Data on sociodemographic characteristics, anemia, pregnancy-induced hypertension (PIH), thyroid dysfunction, and nutritional status were collected using predefined operational definitions. Logistic regression determined the independent risk factors Results: The mean maternal age was 30.3 ± 4.2 years among cases and 29.3 ± 4.5 years among controls. Anemia and hypothyroidism were significantly associated with IUGR in multivariate analysis (aOR=4.23; 95% CI: 1.60–11.19; p=0.004 and aOR=6.04; 95% CI: 1.61–22.68; p=0.008, respectively). PIH showed significance in univariate analysis but lost significance after adjustment. Maternal underweight and hyperthyroidism were not independently associated with IUGR. Conclusions: Maternal anemia and hypothyroidism emerged as independent risk factors for IUGR, highlighting the need for routine screening and early interventions during pregnancy to improve neonatal outcomes.