A multicentre development and evaluation of a dietetic referral score for nutritional risk in sick infants

Gerasimidis, Konstantinos; Milani, Shamsi; Tester, Andrew; Purcell, Orla; Woodley, Catriona; Tsiountsioura, Melina; Koulieri, Alexandra; Zerva, Ourania; Loizou, Konstantina; Rafeey, Mandana; Kontogianni, Meropi D.; Wright, Charlotte

doi:10.1016/j.clnu.2018.08.017

Cited by 9 publications

(22 citation statements)

References 16 publications

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“…However so far there have been very few studies in this young age group. A similar recent study in infants aged 1–12 months found low rates of malnutrition in hospitalised infants in the UK, but much higher rates in a tertiary referral unit in Iran 7. Similar rates of undernutrition have been reported previously in another Nigerian hospital-based study,26 but it was not clear there how much this simply reflected the high background prevalence of undernutrition in Nigeria 27.…”

Section: Discussionmentioning

confidence: 48%

“…Anthropometric Z-scores were calculated using the WHO anthropometric software, adjusted for gestational age at birth 24. Due to the lack of skinfold norms for infants under 3 months, a threshold of 10 mm for sum of skinfolds (SSF) was used to define low skinfolds, based on the empirical lower limit observed across the first year in a UK survey 7 20. CWG is a measure of WAZ change which adjusts for regression to the mean, the tendency for small infants to catch up toward the median and for larger infants to drift down toward the median 25.…”

Section: Methodsmentioning

confidence: 99%

“…Childhood undernutrition at hospital admission has been reported as a problem even in affluent countries5 6 and when there is a higher background prevalence of malnutrition, admission may exacerbate and perpetuate the cycle of undernutrition, while malnutrition in hospitalised children increases the risk for complications and may prolong hospital stay 7. Despite this, studies from hospitalised children living in resource-poor settings are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting

2019

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PurposeWe aimed to describe the prevalence of undernutrition in hospitalised infants aged under 6 months and test the utility of simple index measures to detect undernutrition.DesignDiagnostic accuracy study: weight, length, mid-upper arm circumference (MUAC), triceps and subscapular skinfolds were measured in infants aged 2 weeks to 6 months admitted to a Teaching Hospital in Enugu, Nigeria. Index criteria: low (<−2SD) weight-for-age Z-scores (WAZ), weight-for-length Z-scores (WLZ); MUAC <11 cm. Reference definition: weight faltering (conditional weight gain below fifth percentile for healthy Nigerian infants) or sum of skinfolds (SSF) <10 mm.ResultsOf 125 hospitalised infants, only 5% (6) were admitted specifically for undernutrition, but low SSF were found in 33% (41) and, 24% (25) with known birth weight had weight faltering, giving an undernutrition prevalence of 36%. Low WAZ was the most discriminating predictor of undernutrition (sensitivity 69%, positive predictive value 86%, likelihood ratio 5.5; area under receiver operator curves 0.90) followed by MUAC (73%, 73%, 4.9; 0.86), while WLZ performed least well (49%, 67%, 2.9; 0.84). Where both MUAC and WAZ were low, there was sensitivity 90%, positive predictive value 82% and likelihood ratio 8.7.ConclusionsInfants aged under 6 months admitted to hospital in Nigeria had a high prevalence of undernutrition. In young, high-risk population, a low WAZ alone was a valuable screening criterion, while combining weight with MUAC gave even higher discrimination. Measurement of length to calculate WLZ was a less useful predictor in this population.

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Section: Discussionmentioning

confidence: 48%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting

2019

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“…Gerasimidis et al 25 reported on the development of a nutrition screening tool for infants <12 months of age. This tool utilized three simple screening questions and a standardized male/female weight chart to determine a nutrition risk score.…”

Section: Patient Populations and Settingsmentioning

confidence: 99%

Pediatric malnutrition screening and assessment tools: Analyzing the gaps

Becker

Brunet-Wood²

2021

Nut in Clin Prac

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Pediatric healthcare professionals know that children who are malnourished have worse clinical outcomes than do their well‐nourished peers. The body of evidence in the literature on the topic of pediatric malnutrition (PMN) is growing and supports this conclusion. The goal of this article is to present the current state of practice related to PMN screening, the use of malnutrition risk screening (MNRS) tools, malnutrition assessment, and the use of malnutrition assessment tools. The purpose is also to discuss best practice for MNRS and assessment and to consider the gaps in practice where additional work is needed.

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“…Z-scores allow comparisons across ages and sexes, but also is good for evaluating the longitudinal changes in body growth (Wang & Chen, 2012). Besides, it is widely used in BMI parameter (Gerasimidis et al, 2019;Gillman et al, 2006;Koletzko et al, 2009;Stephens et al, 2018;Yang et al, 2017), with skinfold variables (Chukwu et al, 2016;Gerasimidis et al, 2019;Moon et al, 2015), but also with the sum of different skinfolds (McDade et al, 2007;Sletner et al, 2013). For the study here presented, Σ 3 SKF z-score regressed by chronological ages may display in which ages, number of standard deviations are away from the average of the skinfolds displayed in our sample.…”

Section: Anthropometric Measuresmentioning

confidence: 99%

Sex‐specific differences in somatic investment and strategies of physical activity among Portuguese schoolchildren

et al. 2021

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Objectives: Physical activity (PA) is required for healthy growth, development, and maturation and plays an important role in the prevention of overweight and obesity in childhood and adolescence. Sex-differences in PA levels are well documented, with boys spending more time in PA, especially in moderate-to-vigorous activities. Following the Life History Theory, our aim is to study if PA affects the fat tissues increases during childhood and juvenile phases in both sexes.Methods: Time spent in sedentary, light, and moderate-to-vigorous PA levels were measured in a sample of 415 Portuguese children and juveniles (207 females/208 males; aged 6-11 years), using an accelerometer for 7 days.Skinfolds related with body fat were objectively collected and socioeconomic status factors were reported using a parental questionnaire. Results:The outcomes show that girls' and boys' fat variables increased during the end of the childhood and the juvenile phase. However, these variables were differently affected by PA. Girls increased fat variables with the sedentary activity while boys decreased fat variables with moderate-to-vigorous PA. Alike, active boys but not girls reduced the fat increase tendency with age.Conclusions: Although both sexes displayed a general fat increment with age, moderate-to-vigorous PA dampens the increase only in boys. In fact, active girls increased body fat in the same manner as non-active girls. From an evolutionary perspective, it could explain sex-specific somatic strategies related to future reproduction or, with future mating and intrasexual competition.

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A multicentre development and evaluation of a dietetic referral score for nutritional risk in sick infants

Abstract: https://clinicaltrials.gov/ct2/show/NCT03323957.

Cited by 9 publications

References 16 publications

Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting

Criteria for undernutrition screening in hospitalised infants under 6 months: a diagnostic accuracy study in a resource-poor setting

Pediatric malnutrition screening and assessment tools: Analyzing the gaps

Sex‐specific differences in somatic investment and strategies of physical activity among Portuguese schoolchildren

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