Related Experiment Videos
Development of a practical screening tool to identify preterm, low-birthweight neonates in Ethiopia
E G Raymond1, N Tafari, J F Troendle
1Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852.
Insights
A simple screening tool using head and chest circumference can identify high-risk preterm and low-birthweight infants. This practical method aids early paediatric care referrals in developing countries where measurements are often unavailable.
Area of Science:
- Neonatal Medicine
- Paediatric Screening
- Global Health
Background:
- Preterm and low-birthweight (LBW) infants face significant neonatal mortality and morbidity risks.
- Accurate measurement of birthweight and gestational age is challenging in developing countries.
- A practical screening tool for identifying high-risk newborns is crucial.
Purpose of the Study:
- To develop and validate a simple screening algorithm using neonatal body measurements.
- To identify preterm and low-birthweight infants in resource-limited settings.
- To improve early referral for special paediatric care.
Main Methods:
- A study of 843 singleton infants in Addis Ababa, Ethiopia.
- Accurate recording of gestational age, birthweight, and body measurements (head, chest circumference, length).
- Development of a predictive algorithm using recursive partitioning on a training group.
Main Results:
- The algorithm classified infants as high-risk if head circumference ≤31 cm or chest circumference ≤30 cm.
- The screening tool demonstrated sensitivity, specificity, and negative predictive value above 90% in the validation group.
- The tool accurately predicted preterm and LBW births.
Conclusions:
- Neonatal body measurements can be combined into a pragmatic and accurate screening tool.
- This tool is suitable for clinical use in developing countries for identifying high-risk infants.
- The screening method facilitates timely referral for essential paediatric care.
Abstract:
Preterm, low-birthweight (LBW) newborn infants are at high risk of neonatal mortality and morbidity and need early referral for special paediatric care. In developing countries, birthweight and gestational age often cannot be measured and a practical screening tool based on surrogate neonatal body measurements to identify high-risk infants would be very useful. We studied a consecutive series of 843 singleton infants born at a referral hospital in Addis Ababa, Ethiopia. Gestational age, birthweight, and four body measurements (chest, head, and mid-arm circumferences and length) were accurately recorded. We randomly divided the series into equal-sized training and validation groups. In the training group, we used a recursive partitioning technique to develop a simple predictive algorithm--infants were classified as high risk if head circumference was 31 cm or less or if chest circumference was 30 cm or less, and were classified as low risk otherwise. When tested in the validation group, this algorithm had sensitivity, specificity, and negative predictive value for prediction of preterm and LBW births above 90%. Thus, neonatal body measurements can be combined into a pragmatic, accurate screening tool suitable for clinical use in developing countries.