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[Intrauterine growth retardation in Peru: stressors and perinatal outcomes Hospital Ministry of Health].

OBJECTIVE
To determine the incidence, stressors and perinatal outcomes of intrauterine growth retardation in the hospitals of the Ministry of Health of Peru.


MATERIAL AND METHODS
Cross-sectional, analytical, case-control study of 9777 infants with intrauterine growth retardation (IUGR) in 29 hospitals of the Ministry of Health of Peru in 2010. The Peruvian intrauterine growth curve was used for the diagnosis of IUGR. IUGR newborns (cases) and newborns appropriate for gestational age (controls) were compared using the odds ratio (OR) with a confidence interval of 95%.


RESULTS
The incidence of IUGR was 10.1%. The incidence by region was: 8.1% Coast, 11.8% Selva and Sierra 14.6%. The frequency of stress factors of IUGR were: nutrition (92%), psychological (84.8%), social (53%), anatomical (63.6%), toxic/environmental (52.9%), vascular (29,8%), infection (14.1%) and metabolic (0.3%). The newborn with IUGR had higher perinatal morbidity (OR=2,1) and mortality (OR=3.5).


CONCLUSION
The healthy fetus is the result of a balance between stress factors and the adaptive response of the mother and fetus. When the response of physiological adaptation is overcome by stress factors, IUGR occurs.The political, psychological, nutritional and medical intervention before 12 weeks of gestation has the potential to change the harmful effects of all human stress factors that affect fetal growth.