Anthropometric measurements– a study on options for identification of small babies in need of extra care
Abstract
Introduction: A large number of babies born in India and many developing countries are born at home and majority of them have no access to scales or other means by which they can be identified as LBW. The aim of our study was to determine the correlation of chest circumference and foot length with birth weight and gestational age and to determine the most sensitive and specific cut-off values for detection of Low birth weight and preterm babies using foot length and chest circumference.
Methods: This was a prospective observational study done at a tertiary care centre in south India. We analyzed 1000 newborn babies within 24 hours of birth. For each baby we measured 1. chest circumference (CHC), 2. Foot length (FL), 3. Weight (BW) and 4. Gestational age (GA). Babies were classified according to GA (pre-term/term) and BW (kg) as Very Low Birth Weight (VLBW) (<1.5kg), Low Birth Weight (LBW) (1.5-2.5kg) and Normal Birth Weight (NBW) (>2.5kg).
Results: Significant positive correlation of 0.921 was found between FL and BW (p<0.001). The two ROC curves for FL and CHC were close to each with AUC 0.982 and 0.969 respectively and difference in the areas was statistically significant (Z = 4.303, p < 0.0001) which suggested that FL was better indicator of BW. FL <= 6.4cm predicts VLBW; between 6.4cm and 7.3cm predicts LBW and > 7.3cm predicts NBW. For estimating preterm birth FL cut off was <=7.1cm.
Conclusion: FL and CHC both can be used as predictor for BW and GA estimation and FL was more appropriate than CHC considering its ease of measurement also. Screening of babies who are in need of extra care can be done using our cut off values and this can help in reducing neonatal mortality by early referrals.
Downloads
References
2. Sankar MJ, Neogi SB, Sharma J, et al. State of newborn health in India. Journal of Perinatology. 2016;36(Suppl 3):S3-S8. doi:10.1038/jp.2016.183.
3. Lawn JE, Kerber K, Enweronu-Laryea C, et al. Newborn survival in low resource settings--are we delivering? BJOG. 2009 Oct;116 Suppl 1:49-59. doi: 10.1111/j.1471-0528.2009.02328.x.[pubmed]
4. Baqui AH, Ahmed S, El Arifeen S, et al. Effect of timing of first postnatal care home visit on neonatal mortality in Bangladesh: a observational cohort study. BMJ. 2009 Aug 14;339:b2826. doi: 10.1136/bmj.b2826.
5. James DK, Dryburgh EH, Chiswick ML. Foot length--a new and potentially useful measurement in the neonate. Arch Dis Child. 1979 Mar;54(3):226-30.[pubmed]
6. Daga SR, Daga AS, Patole S, et al. Foot length measurement from foot print for identifying a newborn at risk. J Trop Pediatr. 1988 Feb;34(1):16-9. doi: 10.1093/tropej/34.1.16.[pubmed]
7. Hirve SS, Ganatra BR. Foot tape measure for identification of low birth weight newborns. Indian Pediatr. 1993 Jan;30(1):25-9.[pubmed]
8. Mullany LC, Darmstadt GL, Khatry SK, et al. Relationship between the surrogate anthropometric measures, foot length and chest circumference and birth weight among newborns of Sarlahi, Nepal. Eur J Clin Nutr. 2007 Jan;61(1):40-6. Epub 2006 Aug 2.[pubmed]
9. Mathur A, Tak SK, Kothari P. 'Foot length'--a newer approach in neonatal anthropometry. J Trop Pediatr. 1984 Dec;30(6):333-6. doi: 10.1093/tropej/30.6.333.[pubmed]
10. Marchant T, Jaribu J, Penfold S, et al. Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital based study with community follow-up in Tanzania. BMC Public Health. 2010 Oct 19;10:624. doi: 10.1186/1471-2458-10-624.
11. Das JC, Afroze A, Khanam ST, et al. Mid-arm circumference: an alternative measure for screening low birth weight babies. Bangladesh Med Res Counc Bull. 2005 Apr;31(1):1-6.[pubmed]
12. Sharma JN, Saxena S, Sharma U. Thigh circumference at birth as the best predictor of low birth weight babies. Indian Pediatr. 1989 Jan;26(1):18-21.[pubmed]
13. Kadam YR, Somaiya P, Kakade SV: A study of surrogate parameters of birth weight. Indian J Community Med 2005, 30(3):89–91.doi: 10.4103/0970-0218.42857.
14. Vishnu Datt Pandey, Vishram Singh , G L Nigam , Yasmeen Usmani , Yogesh Yadav: Fetal Foot Length for Assessment of Gestational Age: A Comprehensive Study in North India. Sch. J. App. Med. Sci., 2015; 3(1C):139-144.
15. Mhaskar R Agarwal, N Takkar, D Buckshee, K Anandalakshmi, and Deorari A. Fetal foot length — a new parameter for assessment of gestational age. International Journal of Gynecology & Obstetrics, 1989;29:35-38. doi:10.1016/0020-7292(89)90126-4
16. Mercer BM, Sklar S, Shariatmadar A, et al. Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol. 1987 Feb;156(2):350-5.[pubmed]
17. Kulkarni ML, Rehman M Neonatal assessment beyond birth weight, Indian Pediatr , 1991, vol. 28(pg. 929-31).[pubmed]
18. Elizabeth NL, Christopher OG, Patrick K. Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study. BMC Pediatr. 2013 Apr 12;13:54. doi: 10.1186/1471-2431-13-54.[pubmed]
19. Dhananjay B. NaikA. P. KulkarniN. R. Aswar. Birth weight and anthropometry of newborns. The Indian Journal of Pediatrics. 2003;70(2):145-146.[pubmed]
20. Taksande A, Vilhekar KY, Chaturvedi P, et al. Predictor of low birth weight babies by anthropometry. J Trop Pediatr. 2007 Dec;53(6):420-3. Epub 2007 Jun 15. DOI:10.1093/tropej/fmm052.[pubmed]
21. Sajjadian N, Shajari H, Rahimi F, Jahadi R, Barakat MG. Anthropometric measurements at birth as predictors of low birth weight. Health. 2011;3(12):752–756. doi: 10.4236/health.2011.312125.
22. Sreeramareddy CT, Chuni N, Patil R, et al. Anthropometric surrogates to identify low birth weight Nepalese newborns: a hospital-based study. BMC Pediatr. 2008 Apr 25;8:16. doi: 10.1186/1471-2431-8-16.[pubmed]
23. Satarupa Mukherjee, Prithwish Roy: Measuring New Born Foot Length to Identify Small Babies in Need of Extra Care:a Cross-Sectional Hospital Based Study. Iran J Pediatr 2013;23(5): 508-512.
24. Ballard JL, Khoury JC, Wedig K, et al. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991 Sep;119(3):417-23.[pubmed]
25. Anshuman Srivastava, Utkarsh Sharma, Sumit Kumar. To study correlation of foot length and gestational age of new born by new Ballard score; Int J Res Med Sci. 2015 Nov;3(11):3119-3122DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151147.
26. Wabwire-Mangen F, Kigozi G, Gray RH. Estimation of birth weight and gestational age during the first two weeks of life among home deliveries. Int J Gynaecol Obstet. 2002 Dec;79(3):255-7.[pubmed]
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
