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Intrauterine growth predictors
M Mohan1, H K Chellani, S R Prasad
1Department of Pediatrics, Safdarjang Hospital, New Delhi.
Insights
Midarm circumference (MAC) and MAC/head circumference (HC) ratio can identify neonates at risk for metabolic issues. MAC is a reliable substitute for weight in identifying low birth weight neonates.
Area of Science:
- Neonatal research
- Pediatric anthropometry
- Public health nutrition
Background:
- Accurate identification of neonates at risk for metabolic complications is crucial.
- Birth weight is a key indicator of neonatal health but can be difficult to measure accurately in all settings.
- Alternative anthropometric measures are needed to assess neonatal health and identify low birth weight.
Purpose of the Study:
- To establish standards for midarm circumference (MAC) and MAC/head circumference (HC) ratio for identifying at-risk neonates.
- To evaluate anthropometric variables as substitutes for weight in identifying low birth weight neonates.
Main Methods:
- A study involving 2925 consecutive live births.
- Correlation analysis between various anthropometric variables and gestational age.
- Assessment of MAC, MAC/HC ratio, and ponderal index (PI) for their correlation with gestation.
- Determination of the best anthropometric marker for birth weight prediction.
Main Results:
- Significant correlations were found between studied anthropometric variables (p ≤ 0.001).
- MAC, MAC/HC ratio, and PI showed the least correlation with gestation, making them suitable independent markers.
- MAC demonstrated the strongest correlation with birth weight (r = 0.808).
- Specific MAC thresholds (≤8.6 cm and ≤7.4 cm) showed high sensitivity and specificity for identifying neonates weighing ≤2500 g and ≤2000 g, respectively.
- All studied anthropometric variables exhibited high negative predictive values (>90%) for ruling out low birth weight.
Conclusions:
- Midarm circumference (MAC) and MAC/head circumference (HC) ratio can be valuable tools for identifying neonates at risk for metabolic complications.
- MAC serves as a reliable anthropometric substitute for birth weight in identifying low birth weight neonates, particularly when direct weight measurement is challenging.
- Established MAC standards offer a practical approach to neonatal screening and health assessment in diverse clinical settings.
Abstract:
The present study was conducted to construct standards for midarm circumference and midarm/head circumference ratio to identify neonates at risk for metabolic complications and to assess the anthropometric variable which could be used to substitute weight to identify low birth weight neonates. A study of 2925 consecutive live births showed significant correlation (p less than or equal to 0.001) between different anthropometric variables studied. Since midarm circumference (MAC), midarm circumference/head circumference ratio (MAC/HC) and ponderal index (PI) had the least correlation with gestation, these were used as independent markers for gestation. Among these three, MAC had the best correlation with birth weight (r = 0.808). A midarm circumference of less than or equal to 8.6 cm and less than or equal to 7.4 cm had the best sensitivity and specificity for identifying neonates with a birth weight of less than or equal to 2500 and less than or equal to 2000 g, respectively. All the anthropometric variable studied can rule out low birth weight with great accuracy (high negative predictive value greater than 90%).