Chest circumference in full-term newborns: how can it be predicted?

The head circumference to chest circumference ratio provided an easy way to detect foetal growth restriction in term infants

AIM

The head circumference to chest circumference (HC/CC) ratio has been used to identify low birth weight infants in developed countries. This study was conducted to examine whether the ratio could distinguish asymmetrical foetal growth restriction (FGR).

METHODS

This retrospective observational study was conducted with 1955 infants (50.5% male) born at term between 2016 and 2020 at Tokyo Metropolitan Toshima Hospital, Japan.

RESULTS

We found that 120 (6.1%) had FGR. Their mean birth weight was 3052.1 ± 367.3 g, and their mean gestational age was 39.1 ± 1.1 weeks. Logistic regression analysis showed that the association between the HC/CC ratio and FGR had a regression coefficient of -20.6 (p < 0.000). The linear regression analysis showed that the association between the HC/CC ratio and the birth weight z-score had a regression coefficient of -8.59 (p < 0.000). The coefficient of correlation was -0.33 (p < 0.001). The receiver operating characteristic curve for detecting FGR showed that the area under the curve was 0.75 and the cut-off value was 0.93, with sensitivity of 75.8% and specificity of 60.8%.

CONCLUSION

Our study established the associations between HC/CC ratio and FGR and birth weight z-scores and confirmed that the ratio provided an easy way to detect FGR in term-born infants.

Estimating gestational age using the anthropometric measurements of newborns in North Shewa Zone public hospitals, Oromia, Ethiopia

Background

The accurate estimation of gestational age is crucial in identifying prematurity and other health problems in newborns and in providing appropriate perinatal care. Although there are numerous methods for measuring gestational age, they are not always applicable. During these situations, it becomes challenging to ascertain whether a baby has been born prematurely or not. Therefore, this study aims to estimate gestational age by utilizing newborn anthropometric parameters.

Purpose

The objective of this study is to estimate the gestational age of newborns in public hospitals located in the North Shewa Zone of the Oromia Region in Ethiopia, by using anthropometric parameters.

Methods

A cross-sectional study was conducted at a facility from February 2022 to April 2022, using an interview-based questionnaire and anthropometric measurements. The anthropometric parameters that were measured include foot length (FL), mid-upper arm circumference (MUAC), and chest and head circumference (CHC). The study's sample size had a total of 420 participants. The data were cleaned, edited, manually checked for completeness, and entered into Epi-data version 3.1. Subsequently, the data were transferred into SPSS for analysis. The data were analyzed using descriptive analysis, simple linear regression, and multiple linear regressions. Finally, the data were presented using statements and tables.

Results

There is a significant and positive correlation between anthropometric parameters, including head circumference (r: 0.483), MUAC (r: 0.481), foot length (r: 0.457), and chest circumference (r: 0.482) with gestational age. All anthropometric parameters demonstrated positive and significant estimates of gestational age. The combination of the four measurements yielded the strongest estimate of gestational age. Gestational age can be calculated by the formula: Gestational age (Weeks) = 9.78 + 0.209*CHC + 0.607*MUAC + 0.727*FL + 0.322*HC.

Conclusion

Gestational age can be measured using head circumference, mid-upper arm circumference, foot length, and chest circumference. Utilizing the four anthropometric parameters in combination exhibits greater efficacy in estimating gestational age than using them individually. Therefore, it is recommended to use these alternative approaches when standard methods are not applicable.

Skin-Integrated Devices with Soft, Holey Architectures for Wireless Physiological Monitoring, With Applications in the Neonatal Intensive Care Unit

Continuous monitoring of vital signs is an essential aspect of operations in neonatal and pediatric intensive care units (NICUs and PICUs), of particular importance to extremely premature and/or critically ill patients. Current approaches require multiple sensors taped to the skin and connected via hard-wired interfaces to external data acquisition electronics. The adhesives can cause iatrogenic injuries to fragile, underdeveloped skin, and the wires can complicate even the most routine tasks in patient care. Here, materials strategies and design concepts are introduced that significantly improve these platforms through the use of optimized materials, open (i.e., "holey") layouts and precurved designs. These schemes 1) reduce the stresses at the skin interface, 2) facilitate release of interfacial moisture from transepidermal water loss, 3) allow visual inspection of the skin for rashes or other forms of irritation, 4) enable triggered reduction of adhesion to reduce the probability for injuries that can result from device removal. A combination of systematic benchtop testing and computational modeling identifies the essential mechanisms and key considerations. Demonstrations on adult volunteers and on a neonate in an operating NICUs illustrate a broad range of capabilities in continuous, clinical-grade monitoring of conventional vital signs, and unconventional indicators of health status.

Feasibility of unconstrained three-material decomposition: imaging an excised human heart using a prototype silicon photon-counting CT detector

Rationale and objectives

The purpose of this study was to evaluate the feasibility of unconstrained three-material decomposition in a human tissue specimen containing iodinated contrast agent, using an experimental multi-bin photon-counting silicon detector. It was further to evaluate potential added clinical value compared to a 1st-generation state-of-the-art dual-energy computed tomography system.

Materials and methods

A prototype photon-counting silicon detector in a bench-top setup for x-ray tomographic imaging was calibrated using a multi-material calibration phantom. A heart with calcified plaque was obtained from a deceased patient, and the coronary arteries were injected with an iodinated contrast agent mixed with gelatin. The heart was imaged in the experimental setup and on a 1st-generation state-of-the-art dual-energy computed tomography system. Projection-based three-material decomposition without any constraints was performed with the photon-counting detector data, and the resulting images were compared with those obtained from the dual-energy system.

Results

The photon-counting detector images show better separation of iodine and calcium compared to the dual-energy images. Additional experiments confirmed that unbiased estimates of soft tissue, calcium, and iodine could be achieved without any constraints.

Conclusion

The proposed experimental system could provide added clinical value compared to current dual-energy systems for imaging tasks where mix-up of iodine and calcium is an issue, and the anatomy is sufficiently small to allow iodine to be differentiated from calcium. Considering its previously shown count rate capability, these results show promise for future integration of this detector in a clinical CT scanner.

Key Points

• Spectral photon-counting detectors can solve some of the fundamental problems with conventional single-energy CT.

• Dual-energy methods can be used to differentiate iodine and calcium, but to do so must rely on constraints, since solving for three unknowns with only two measurements is not possible. Photon-counting detectors can improve upon these methods by allowing unconstrained three-material decomposition.

• A prototype photon-counting silicon detector with high count rate capability allows performing unconstrained three-material decomposition and qualitatively shows better differentiation of iodine and calcium than dual-energy CT.