الفهرس 
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Abstract
Intrauterine growth restriction (IUGR) is a condition that greatly elevates the risk of illness and death among fetuses and infants. As per its definition, it refers to a fetal growth rate that is slower than the expected speed based on the infant’s developmental ability.
Antenatal, also known as gestational age (SGA), describes a fetus with a weight that falls below the 10th percentile. IUGR and SGA are frequently employed interchangeably. Identifying intrauterine growth restriction (IUGR) is of utmost importance. The method of determining intrauterine growth restriction (IUGR) begins with assessing the risk factors. The diagnosis is validated by ultrasound examination, specifically by assessing biometric signs that show an estimated fetal weight (EFW) below the 10th percentile. The incidence of intrauterine growth restriction (IUGR) varies among different countries, societies, and ethnicities, and tends to increase as the duration of pregnancy lowers. Intrauterine growth restriction (IUGR) is a commonly observed condition that can occur due to several circumstances, including maternal, placental, fetal, or genetic causes. Furthermore, IUGR can arise due to a combination of any of these factors. Various maternal factors, such as maternal age, interpregnancy interval (less than 6 months or more than 120 months), maternal health, behavioral habits, and maternal infection, influence fetal growth and contribute to the occurrence of intrauterine growth restriction (IUGR).
The objective of this research was to determine the correlation between the dimensions of the embryonic adrenal gland and the occurrence of late fetal growth restriction.
This study was a case-control investigation that included the recruitment of 110 pregnant women. The patients were divided into two groups: 55 pregnant women with fetal growth restriction and 55 women with uncomplicated pregnancies, both groups having similar gestational age. The people did not have any further obstetric complications or medical conditions and delivered their children at the anticipated gestational age. The research was carried out at El-Minia University Hospital.
The research found that the gestational age in the IUGR group varied between 26 and 38 weeks, with an average mother age of 31.5 ±3.0 years. The control group consisted of individuals with gestational ages ranging from 26 to 38 years, with an average maternal age of 32.3 ±3.2 years. No significant differences were seen between the two groups being assessed in terms of mother age, number of pregnancies, number of previous births, and gestational age at the time of study participation.
The research conducted a comparison analysis between pregnancies in the intrauterine growth restriction (IUGR) group and pregnancies in the healthy control group, with a particular focus on quantifying the volume of the adrenal gland (AGV) and the breadth of the medulla. The AGV was markedly elevated in babies with intrauterine growth restriction (IUGR) compared to those with normal estimated fetal weight (EFW) for gestational age in both groups, respectively. In both groups, the breadth of the medulla was considerably greater in the IUGR fetus compared to the healthy controls. When the adrenal gland’s capacity exceeds 283, there is an 87.3% likelihood of properly predicting Intrauterine Growth Restriction (IUGR), with a specificity rate of 60%. A minimum medulla width of 1.35 is associated with a sensitivity of 67.3% and a specificity of 60% in the prediction of intrauterine growth restriction (IUGR).
The Pearson correlation analysis revealed a statistically significant moderate positive linear association between the mother’s age and both AGV and medulla width. Furthermore, a statistically significant and small positive linear connection was seen between gestational age and both AGV and medulla width. However, there was no statistically significant linear link seen between estimated fetal weight (EFW), gravidity, and parity in the group of babies diagnosed with intrauterine growth restriction (IUGR).
The area under the curve (AUC) of the adrenal gland volume, assessed by ROC curve analysis, to predict intrauterine growth restriction (IUGR), was 0.773. A minimum adrenal gland volume of 283 or above may be used as a criterion to predict intrauterine growth restriction (IUGR) with a sensitivity of 87.3% and a specificity of 60%. The AUC for predicting IUGR based on medulla width was 0.665.
A medulla width of at least 1.35 may be used as a threshold to detect intrauterine growth restriction (IUGR) with a sensitivity of 67.3% and a specificity of 60%. The unadjusted regression analysis revealed that maternal age, gravidity, parity, gestational age, and estimated fetal weight were significant predictors of adrenal gland capacity, as shown by a statistically significant p-value. However, after taking into account variables such as maternal age, parity, gravidity, gestational age, and estimated fetal weight in the adjusted regression model, only maternal age, gestational age, and estimated fetal weight were found to be significant predictors of adrenal gland volume. The predictors exhibited statistical significance, as shown by a significant p-value.
The findings of our study revealed a significant disparity in Umbilical Artery Doppler measurements (RI, PI, SD ratio), Apgar score, and Birth weight (kg) between the case and control groups. However, when considering the impact of maternal age, gestational age (GA), and estimated fetal weight (EFW), only GA and EFW were shown to be statistically significant determinants in predicting adrenal gland volume.
An analysis of the data revealed a statistically significant, although modest, positive correlation (r = 0.34, p < 0.05) between the volume of the adrenal gland and the gestational age. In addition, a little positive connection was seen between the medulla width and the gestational age, with a correlation coefficient (r) of 0.25 and a p-value of less than 0.05. Furthermore, a moderate but statistically significant link was seen between the size of the adrenal gland and both the number of pregnancies and the number of live births (correlation coefficients of 0.26 and 0.24, respectively, with a p-value below 0.05).