Mid arm circumference (MAC) and body mass index (BMI)--the two important auxologic parameters in neonates

[Fetal malnutrition assessment program]

OBJECTIVE

To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status.

METHODS

PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed.

RESULTS

Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition (P < 0.05), while there was no significant difference between the combination of BMI+CANS and the combination of PI+BMI+CANS (P > 0.05).

CONCLUSIONS

The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.

Developing nomogram to estimate birth weight from head circumference and mid-upper arm circumference

BACKGROUND

Despite the huge proportion of the babies in the developing world being born low birthweight, only about half of the newborns are weighed at birth as weighing scales often tend to be either non-available or defective.

OBJECTIVE

Designing a nomogram for estimation of birthweight from head circumference (HC) and mid-upper arm circumference (MUAC).

METHOD

Birthweight, HC and MUAC of 500 newborns who were admitted in the baby nursery of Medical College and Hospital, Kolkata between July 2010 to December 2010 were measured.

RESULTS

Multiple linear regression equation for prediction of birth weight from MUAC and HC was derived and a nomogram was constructed from the same.

CONCLUSION

The birthweight estimation nomogram is an inexpensive and convenient tool for use in the community setting where weighing machines may not be always available and may thus allow prompt and early referral.

Monitoring nutritional status accurately and reliably in adolescents with anorexia nervosa

AIM

Accurate assessment of nutritional status is a vital aspect of caring for individuals with anorexia nervosa (AN) and body mass index (BMI) is considered an appropriate and easy to use tool. Because of the intense fear of weight gain, some individuals may attempt to mislead the physician. Mid-upper arm circumference (MUAC) is a simple, objective method of assessing nutritional status. The setting is an eating disorders clinic in a tertiary paediatric hospital in Western Australia. The aim of this study is to evaluate how well MUAC correlates with BMI in adolescents with AN.

METHODS

Prospective observational study to evaluate nutritional status in adolescents with AN.

RESULTS

Fifty-five adolescents aged 12-17 years with AN were assessed between January 1, 2004 and January 1, 2006. MUAC was highly correlated with BMI (r = 0.79, P < 0.001) and individuals with MUAC >or=20 cm rarely required hospitalisation (negative predictive value 93%).

CONCLUSIONS

MUAC reflects nutritional status as defined by BMI in adolescents with AN. Lack of consistency between longitudinal measurements of BMI and MUAC should be viewed suspiciously and prompt a more detailed nutritional assessment.

Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India

OBJECTIVE

To determine the accuracy and acceptability of a handheld scale prototype designed for nonliterate users to classify newborns into three weight categories (>or=2,500 g; 2,000 to 2,499 g; and <2,000 g).

STUDY DESIGN

Weights of 1,100 newborns in Uttar Pradesh, India, were measured on the test scale and validated against a gold standard. Mothers, family members and community health stakeholders were interviewed to assess the acceptability of the test scale.

RESULT

The test scale was highly sensitive and specific at classifying newborn weight (normal weight: 95.3 and 96.3%, respectively; low birth weight: 90.4 and 99.2%, respectively; very low birth weight: 91.7 and 98.4%, respectively). It was the overall agreement of the community that the test scale was more practical and easier to interpret than the gold standard.

CONCLUSION

The BIRTHweigh III scale accurately identifies low birth weight and very low birth weight newborns to target weight-specific interventions. The scale is extremely practical and useful for resource-poor settings, especially those with low levels of literacy.