Anthropometric measures that identify premature and low birth weight newborns in Ethiopia: a cross-sectional study with community follow-up

Abstract

What is already known on this topic?► Worldwide, about one-sixth of all newborns are low birth weight (LBW, <2500 g), which is the single most important underlying risk factor for neonatal death. ► In resource-limited settings, tools to identify LBW and premature newborns are often not readily available. ► Foot length, chest circumference mid-upper arm circumference can be used to identify LBW babies at birth, cut-offs vary by country and ethnic group. What this study adds?► The optimal cut-offs identified to diagnose LBW in Ethiopia were ≤7.7 cm for foot length, ≤31.2 cm for chest circumference and ≤9.8 cm for mid-upper arm circumference. ► Comparable diagnostic ability was observed when these measurements were taken on day 5 of age. ► The Eregie model for gestational age estimation gives similar results to the New Ballard Score method. AbsTrACTObjective To investigate foot length (FL), chest circumference (CHC) and mid-upper arm circumference (MUAC) as predictors of low birth weight (LBW) or prematurity, and to describe the agreement between the gestational age (GA) assessments ascertained by the New Ballard Score (NBS) and the Eregie model. Methods A hospital-based cross-sectional study with community follow-up in a subset was conducted in Jimma University Medical Center, Ethiopia. GA (NBS and Eregie model), weight, FL, CHC and MUAC were measured at birth. Anthropometrics were repeated at 5 days of age. results The optimal cut-offs indicative of LBW were ≤7.7 cm for FL; ≤31.2 cm for CHC and ≤9.8 cm for MUAC. CHC, MUAC and FL identified LBW with sensitivities (95% CI) of 91.6 (86.9 to 95), 83.7 (77.8 to 88.5) and 84.2 (78.4 to 88.9), and specificities (95% CI) of 85.4 (83.3 to 87.4), 90.2 (88.4 to 91.9) and 73.9 (71.3 to 76.4), respectively. CHC, MUAC and FL identified prematurity with sensitivities of 83.8 (76.7 to 89.4), 83.1 (75.9 to 88.9) and 81.7 (74.3 to 87.7), and specificities of 81.1 (78.9 to 83.3), 63.4 (60.7 to 66.1) and 77.0 (74.6 to 79.3), respectively. The cut-offs identified have comparable diagnostic ability for LBW and prematurity when measurements are repeated on day 5 of age. The GA assessment by the NBS and the Eregie model gave similar results, with the mean difference of 1.2 weeks. Conclusion CHC, MUAC and FL taken on day 1 and 5 after birth could be used as diagnostic tools for LBW or prematurity. The Eregie model for GA estimation gives similar results to the NBS.

Relationship Between Foot Length And Gestational Age In Pakistan

“…The most commonly used equipment was a Vernier caliper (16,17,19,20), followed by transparent rigid scales and steel or exible tapes. (10,18,21) The unit of measurement was also different across studies. Some used centimeters (16)(17)(18) and some millimeters.…”

“…(6) If the antenatal GA is unknown, then the post-natal assessment may provide a reasonable estimation of GA. Postnatal assessment of GA can be assessed by using different techniques, for example, through Dubowitz scoring (7), New Ballard Scoring (8), Eregie model (9) and measurement of different parts of the body, such as chest circumference, leg length, foot length, etc. (10,11). Nevertheless, both antenatal and postnatal estimations of GA have some limitations.…”

“…In low-middle-income countries like Pakistan where female illiteracy is high, women generally are unable to recall their LMP (10) and a good quality rst-trimester ultrasound report is not commonly available. In such cases, Ballard scoring is the most commonly used post-natal method to determine the GA of the baby.…”

“…However, Ballard scoring is technical and subjective for health care workers to use and estimate the GA accurately. (10) In resource-poor settings where the US is not available and Ballad scoring is challenging, one of the simple ways to estimate GA is the measurement of post-natal foot length. Health care workers can measure foot length with minimal training and can estimate GA.…”

Relationship Between Foot Length and Gestational Age in Pakistan

“…The most commonly used equipment was a Vernier caliper (16,17,19,20), followed by transparent rigid scales and steel or exible tapes. (10,18,21) The unit of measurement was also different across studies.…”