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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Assessment of Changes in the Morphometric Measurements of the Abdomen in Children with Age
Pute U Losu1, Yogesh Kumar Sarin1
1Department of Pediatric Surgery, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
Insights
Abdominal shape changes with age in children. A study found that a transverse abdominal skin incision is best for infants under 11 months, while vertical incisions are suitable for older children.
Area of Science:
- Pediatric Surgery
- Anatomy
- Growth and Development
Background:
- Abdominal wall morphometrics significantly change with age in children.
- Understanding these changes is crucial for selecting appropriate surgical approaches.
Purpose of the Study:
- To correlate abdominal wall morphometric measurements with age in pediatric patients.
- To establish a nomogram for abdominal shape changes during childhood.
- To guide the selection of age-appropriate abdominal skin incisions.
Main Methods:
- A prospective observational study was conducted with 400 pediatric patients (newborns to 18 years).
- Morphometric measurements of the abdominal wall (vertical and transverse diameters) were recorded.
- Statistical analysis, including ROC curve analysis, was used to determine age-related cutoffs.
Main Results:
- The study included 400 patients (mean age 5.05 ± 4.3 years; 71.5% male).
- Vertical abdominal diameter (xipho-pubic AB) averaged 19.83 cm, transverse diameter (EF) 15.98 cm, and the EF/AB ratio 0.83.
- Age was a significant predictor of abdominal shape, with a cutoff of 0.92 years identified for EF/AB <1.
Conclusions:
- The optimal cutoff age for differentiating between transverse and vertical abdominal skin incisions is 11 months.
- Vertical skin incisions are generally preferred for most pediatric age groups.
- Transverse incisions may be considered for children younger than 11 months.
Introduction:
Significant changes occur in the shape and size of the abdomen with age. We aimed to correlate the morphometric measurements of the abdominal wall with age and establish a nomogram to demonstrate that the shape of the abdomen changes as a child grows, highlighting the need to choose different abdominal skin incisions as per age in children.
Materials And Methods:
A single-center prospective observational study was carried out from July 2023 to December 2024. All consecutive patients in the age groups of term newborns to 18 years visiting the department of Pediatric Surgery of a tertiary teaching hospital were enrolled in our study. The demographic and abdominal parameters were recorded.
Results:
Four hundred patients were included in the study. The mean age was 5.05 ± 4.3 years. There were 286 (71.5%) males and 114 (28.5%) females. The mean values of xipho-pubic AB (vertical diameter), EF (transverse diameter), costo-iliac, and EF/AB (transverse diameter/vertical diameter) were 19.83 ± 4.72 cm, 15.98 ± 2.32 cm, 9.02 ± 1.89 cm, and 0.83 ± 0.14, respectively. 92.25% (n = 369) of cases qualified for vertical skin incision, while only 7.75% (n = 31) qualified for transverse skin incision. Interpretation of the area under the receiver operating characteristic curve showed that the performance of age fell into the "outstanding" category. Based on this, it can be asserted that 0.92 years is the age at which EF/AB is <1, with a sensitivity of 88.1% and specificity of 83.9%.
Conclusion:
The cutoff age between transverse and vertical abdominal skin incisions was determined to be 11 months. The vertical skin incision was the preferred option for all age groups. A transverse skin incision may be considered in children under 11 months of age.
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