[Etiologic factors of fetal hypotrophy. Apropos of 600 cases].
The authors have studied 600 cases histories of fetal growth retardation over a period of 11 years from 1970 to 1981. The incidence of growth retardation was 600 cases in 24,906 deliveries from October 1970 to the end of 1981. This gives an incidence of 2.41%. This figure tends to get less progressively, going from 2.5% at the beginning of our study to a little more than 2% in the last years. 1,498 babies were born weighing less than 2,500 g: 600 of them were really true intra-uterine growth retardations (40%) and 898 were babies born prematurely with normal weight for their gestational age. 227 of the 600 small for date babies were born before the 38th week of pregnancy (37.8%). Girls represented 55% of the cases of growth retardation. There was no significant difference in the distribution of age groups of the mothers of small for date babies and the control population. 57% of the women were primiparas whereas only 38% were primiparas in the control population. There is a close relationship between primiparity and young maternal age. 80% of mothers who were under 25 years of age were primiparas. The height of the mother, less than 1,50 m, in our study was significantly less than in the control population (11.9% as against 2.5%). 24% of the mothers weighed less than 45 kg as compared with 7.1% in the general population. The weight gain was not significantly different from that in the control population, if it is not taken in account of mothers who had toxaemia of pregnancy. 158 cases out of the 600, which represents 26% of the mothers, had toxaemia of pregnancy and this confirms how important this aetiological factor is in intra-uterine growth retardation. 113 placentas (18.8%) were studied. They showed histological abnormalities such as infarcts (47 cases) and ischaemic necrosis (18 cases). These features are often associated with toxaemia of pregnancy and/or heavy maternal smoking in 58% of cases. There were abnormalities of the umbilical cords. These were variable so that one could not say that any one was an important cause of intra-uterine growth retardation. A single umbilical artery was found in 8 cases (1.33%). We only speak of recurrent fetal growth retardation, excluding cases of toxaemia, when three or more small for date babies have been born without any particular aetiological reason.(ABSTRACT TRUNCATED AT 400 WORDS)