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Head circumference/abdominal circumference ratio, ponderal index and fetal malnutrition. Should head
N V Colley1, J M Tremble, G L Henson
1Royal Devon and Exeter Hospital, Heavitree.
Insights
The head circumference/abdominal circumference (HC/AC) ratio is not a reliable indicator for fetal malnutrition. This study found a poor correlation between HC/AC ratios and neonatal wasting, suggesting alternative methods for prediction.
Area of Science:
- Perinatal medicine
- Neonatal anthropometry
- Fetal growth assessment
Background:
- Head circumference/abdominal circumference (HC/AC) ratios are utilized to identify fetal growth patterns and potential malnutrition.
- Ponderal index (PI), calculated as birthweight/length cubed, is a pediatric measure for neonatal wasting.
Purpose of the Study:
- To evaluate the correlation between antenatal HC/AC ratios and neonatal ponderal index.
- To assess the efficacy of HC/AC ratios in predicting intrauterine malnutrition.
Main Methods:
- Analysis of anthropometric data from 999 newborn infants.
- Application of multiple regression analysis to assess correlations between HC/AC ratio, ponderal index, and abdominal circumference (AC) alone.
Main Results:
- A poor correlation was observed between ponderal index and HC/AC ratio.
- The correlation between ponderal index and HC/AC ratio was weaker than that between ponderal index and AC alone.
- Current methods using HC/AC ratios for identifying intrauterine malnutrition subgroups are inadequate.
Conclusions:
- The use of HC/AC ratios for antenatal identification of intrauterine malnutrition subgroups should be discontinued.
- Further research into weight/length ratios for predicting intrauterine malnutrition is recommended.
Abstract:
Head circumference/abdominal circumference (HC/AC) ratios of the fetus are accepted as a means of distinguishing different patterns of growth retardation with a high ratio implying malnutrition of the fetus. Ponderal index (birthweight/length3) is used by paediatricians as a measure of neonatal wasting and would therefore be expected to correlate with HC/AC ratios at delivery. Anthropometric data on 999 newborn infants have been collected and analyzed by multiple regression. The results show a poor correlation between ponderal index and HC/AC ratio, worse than that between ponderal index and AC alone. The use of HC/AC ratios antenatally to identify subgroups of intrauterine malnutrition should be abandoned. The prediction of intrauterine malnutrition by weight/length ratios should be investigated further.
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