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Novel weight estimation equation for children with cerebral palsy in low-resource settings: Validation in a
Israt Jahan1,2,3, Maria de Las Mercedes Ruiz Brunner4,5, Mohammad Muhit1,2
1CSF Global, Dhaka, Bangladesh.
Insights
A new equation accurately estimates weight in children with cerebral palsy (CP) using mid-upper arm circumference (MUAC). This tool is valuable for low-resource settings, aiding nutritional assessment in children with CP.
Area of Science:
- Pediatric Nutrition
- Clinical Anthropometry
- Cerebral Palsy Research
Background:
- Accurate weight estimation is crucial for nutritional assessment and management of children with cerebral palsy (CP).
- Traditional methods may be challenging in resource-limited settings, particularly for children with motor impairments.
- Mid-upper arm circumference (MUAC) offers a practical alternative anthropometric measure.
Purpose of the Study:
- To validate a novel equation for estimating weight from MUAC in children with CP in rural Bangladesh.
- To assess the accuracy and agreement of the MUAC-based weight estimation equation.
Main Methods:
- A cohort of 497 children with CP (aged 2-18 years) was randomly selected from the Bangladesh CP Register.
- Data included sociodemographics, Gross Motor Function Classification System (GMFCS) level, and anthropometric measurements.
- Agreement between observed and estimated weights was evaluated using Bland-Altman plots and Lin's concordance correlation coefficient (CCC).
Main Results:
- Lin's CCC between observed and estimated weights was 0.90 (95% CI 0.89-0.92), indicating strong agreement.
- The mean percentage error was 5.04%, with an average difference of -1.02 kg between observed and estimated weights.
- The equation showed reasonable accuracy, though it was less precise for severely undernourished children (z-scores ≤ -4).
Conclusions:
- The developed equation provides a sufficiently accurate method for estimating weight from MUAC in children with CP.
- This tool is suitable for use in low- and middle-income countries and other low-resource settings.
- MUAC-based weight estimation can support nutritional monitoring for children with CP where direct weight measurement is difficult.
Aim:
To validate a novel equation to estimate weight from mid-upper arm circumference (MUAC) among children with cerebral palsy (CP) in rural Bangladesh.
Method:
Children with CP aged 2 to 18 years registered in the Bangladesh CP Register were randomly selected. Data on sociodemographics, Gross Motor Function Classification System level, and anthropometric measurements were extracted. Bland-Altman plots with a 95% agreement limit and Lin's concordance correlation coefficient with 95% confidence intervals (CI) were reported to measure agreement between observed and estimated weight. Percentage error was used to determinate the method's accuracy.
Results:
There were 497 participants with a mean age at assessment of 9 years (SD 4 years 11 months) (47.7% female). Lin's concordance correlation coefficient between the observed and estimated weights was 0.90 (95% CI 0.89-0.92). Bland-Altman plots showed a reasonable accuracy of the equation in the study cohort. The mean percentage error of the equation was 5.04%. The average difference between observed and estimated weights was -1.02 kg (SD 5.1). The differences between observed and estimated weights were significantly greater among children with weight-for-age, height-for-age, or BMI-for-age z-scores less than or equal to -4.
Interpretation:
It is possible to predict the weight of children with CP from MUAC with sufficient accuracy. The equation can be used for populations in low-resources and low- and middle-income countries.
What This Paper Adds:
The equations predict the weight of children with cerebral palsy from their mid-upper arm circumference reasonably accurately. The difference between observed and estimated weights ranged between 0 kg and ± 5 kg in 81.5% of children. Sex and Gross Motor Function Classification System level did not affect the accuracy of the equations. The equations were less accurate for estimating the weight of severely undernourished children.
