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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Assessment of large and small for gestational age newborn infants using growth curves
1University of Minnesota School of Medicine, Minneapolis, USA.
Insights
Assessing infant anthropometrics after birth helps identify high-risk newborns. A two-tiered approach using standard and specialized measurements distinguishes between high- and low-risk infants for better neonatal care.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Fetal Medicine
Background:
- Abnormal fetal growth is linked to increased neonatal morbidity.
- Early anthropometric assessment post-birth is crucial for risk stratification.
- Identifying at-risk infants promptly can guide timely interventions.
Purpose of the Study:
- To outline a two-tiered approach for assessing neonatal risk based on anthropometric parameters.
- To differentiate between high- and low-risk infants using standard and specialized measurements.
- To enhance the understanding of abnormal fetal growth etiology and associated neonatal risks.
Main Methods:
- Utilizing standard anthropometric measurements: weight, length, and occipitofrontal head circumference.
- Plotting measurements on population-specific growth curves.
- Employing a second tier of assessment with specialty anthropometrics and body proportion analysis when needed.
Main Results:
- Standard anthropometrics (weight, length, head circumference) effectively identify risk in most cases.
- Disproportionate measurements or conflict with clinical history necessitate further assessment.
- Specialty anthropometrics and body proportion analysis provide deeper insights into abnormal growth and risk.
Conclusions:
- A systematic, tiered anthropometric approach improves the identification of infants at risk for neonatal complications.
- Body proportion assessments offer valuable information for defining abnormal fetal growth.
- This methodology aids in refining risk stratification for better neonatal outcomes.
Abstract:
Abnormal fetal growth patterns are associated with higher rates of neonatal morbidity. Measurement of anthropometric parameters immediately after birth, prior to the onset of potential neonatal symptoms, allows the physician to make an assessment as to which infants are at high risk. In general, a two-tiered approach will allow the physician to make the distinction between high- and low-risk infants. First, the standard one-factor anthropometrics--weight, length, and occipitofrontal head circumference--are plotted on curves that are appropriate for the population. In the vast majority of cases, these measurements give enough information regarding neonatal risk. When the standard measurements conflict with the clinical history or are disproportionate, the use of specialty one-factor anthropometrics, and especially two-factor body proportion assessments represent the second tier of assessment that can give greater insights into the etiology of abnormal fetal growth and can further define the groups at risk for neonatal sequelae.
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