Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania
Abstract Background Small-for-gestational-age (SGA) is associated with increased neonatal mortality and morbidity. In low and middle income countries an accurate gestational age is often not known, making the identification of SGA newborns difficult. Measuring foot length, chest circumference and mi...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-04-01
|
| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12887-019-1500-0 |
| _version_ | 1819104304273817600 |
|---|---|
| author | Cecilie Bøge Paulsen Birgitte Bruun Nielsen Omari Abdul Msemo Sofie Lykke Møller Josephine Roth Ekmann Thor Grundtvig Theander Ib Christian Bygbjerg John Peter Andrea Lusingu Daniel Thomas Remias Minja Christentze Schmiegelow |
| author_facet | Cecilie Bøge Paulsen Birgitte Bruun Nielsen Omari Abdul Msemo Sofie Lykke Møller Josephine Roth Ekmann Thor Grundtvig Theander Ib Christian Bygbjerg John Peter Andrea Lusingu Daniel Thomas Remias Minja Christentze Schmiegelow |
| author_sort | Cecilie Bøge Paulsen |
| collection | DOAJ |
| description | Abstract Background Small-for-gestational-age (SGA) is associated with increased neonatal mortality and morbidity. In low and middle income countries an accurate gestational age is often not known, making the identification of SGA newborns difficult. Measuring foot length, chest circumference and mid upper arm circumference (MUAC) of the newborn have previously been shown to be reasonable methods for detecting low birth weight (< 2500 g) and prematurity (gestational age < 37 weeks). The aim of this study was to investigate if the three anthropometric measurements could also correctly identify SGA newborns. Methods In the current study from a rural area of northeastern Tanzania, 376 live newborns had foot length, chest circumference, and MUAC measured within 24 h of birth. Gestational age was estimated by transabdominal ultrasound in early pregnancy and SGA was diagnosed using a sex-specific weight reference chart previously developed in the study area. Receiver operating characteristic curves were generated for each of the anthropometric measurements and the area under the curve (AUC) compared. Operational cutoffs for foot length, chest circumference, and MUAC were defined while balancing as high as possible sensitivity and specificity for identifying SGA. Positive and negative predictive values (PPV and NPV) were then calculated. Results Of the 376 newborns, 68 (18.4%) were SGA. The AUC for detecting SGA was 0.78 for foot length, 0.88 for chest circumference, and 0.85 for MUAC. Operational cut-offs to detect SGA newborns were defined as ≤7.7 cm for foot length, ≤31.6 cm for chest circumference and ≤ 10.1 cm for MUAC. Foot length had 74% sensitivity, 69% specificity, PPV of 0.35 and NPV of 0.92 for identifying SGA. Chest circumference had 79% sensitivity, 81% specificity, PPV of 0.49 and NPV of 0.95 for identifying SGA. Finally, MUAC had 76% sensitivity, 77% specificity, PPV of 0.43 and NPV of 0.94 for identifying SGA. Conclusion In a setting with limited availability of an accurate gestational age, all three methods had a high NPV and could be used to rule out the newborn as being SGA. Overall, chest circumference was the best method to identify SGA newborns, whereas foot length and MUAC had lower detection ability. Trial registration Clinicaltrials.gov (NCT02191683). Registered 2 July 2014. |
| first_indexed | 2024-12-22T02:04:13Z |
| format | Article |
| id | doaj.art-6fed2178435444abba28a56cde49abbd |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-22T02:04:13Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-6fed2178435444abba28a56cde49abbd2022-12-21T18:42:33ZengBMCBMC Pediatrics1471-24312019-04-0119111010.1186/s12887-019-1500-0Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural TanzaniaCecilie Bøge Paulsen0Birgitte Bruun Nielsen1Omari Abdul Msemo2Sofie Lykke Møller3Josephine Roth Ekmann4Thor Grundtvig Theander5Ib Christian Bygbjerg6John Peter Andrea Lusingu7Daniel Thomas Remias Minja8Christentze Schmiegelow9Centre for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenDepartment of Obstetrics and Gynecology, Aarhus University HospitalNational Institute for Medical Research, Tanga CentreSection of Global Health, Department of Public Health, University of CopenhagenCentre for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenCentre for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenSection of Global Health, Department of Public Health, University of CopenhagenNational Institute for Medical Research, Tanga CentreNational Institute for Medical Research, Tanga CentreCentre for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenAbstract Background Small-for-gestational-age (SGA) is associated with increased neonatal mortality and morbidity. In low and middle income countries an accurate gestational age is often not known, making the identification of SGA newborns difficult. Measuring foot length, chest circumference and mid upper arm circumference (MUAC) of the newborn have previously been shown to be reasonable methods for detecting low birth weight (< 2500 g) and prematurity (gestational age < 37 weeks). The aim of this study was to investigate if the three anthropometric measurements could also correctly identify SGA newborns. Methods In the current study from a rural area of northeastern Tanzania, 376 live newborns had foot length, chest circumference, and MUAC measured within 24 h of birth. Gestational age was estimated by transabdominal ultrasound in early pregnancy and SGA was diagnosed using a sex-specific weight reference chart previously developed in the study area. Receiver operating characteristic curves were generated for each of the anthropometric measurements and the area under the curve (AUC) compared. Operational cutoffs for foot length, chest circumference, and MUAC were defined while balancing as high as possible sensitivity and specificity for identifying SGA. Positive and negative predictive values (PPV and NPV) were then calculated. Results Of the 376 newborns, 68 (18.4%) were SGA. The AUC for detecting SGA was 0.78 for foot length, 0.88 for chest circumference, and 0.85 for MUAC. Operational cut-offs to detect SGA newborns were defined as ≤7.7 cm for foot length, ≤31.6 cm for chest circumference and ≤ 10.1 cm for MUAC. Foot length had 74% sensitivity, 69% specificity, PPV of 0.35 and NPV of 0.92 for identifying SGA. Chest circumference had 79% sensitivity, 81% specificity, PPV of 0.49 and NPV of 0.95 for identifying SGA. Finally, MUAC had 76% sensitivity, 77% specificity, PPV of 0.43 and NPV of 0.94 for identifying SGA. Conclusion In a setting with limited availability of an accurate gestational age, all three methods had a high NPV and could be used to rule out the newborn as being SGA. Overall, chest circumference was the best method to identify SGA newborns, whereas foot length and MUAC had lower detection ability. Trial registration Clinicaltrials.gov (NCT02191683). Registered 2 July 2014.http://link.springer.com/article/10.1186/s12887-019-1500-0Small for gestational ageFoot lengthChest circumferenceMid upper arm circumferenceGestational ageAfrica |
| spellingShingle | Cecilie Bøge Paulsen Birgitte Bruun Nielsen Omari Abdul Msemo Sofie Lykke Møller Josephine Roth Ekmann Thor Grundtvig Theander Ib Christian Bygbjerg John Peter Andrea Lusingu Daniel Thomas Remias Minja Christentze Schmiegelow Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania BMC Pediatrics Small for gestational age Foot length Chest circumference Mid upper arm circumference Gestational age Africa |
| title | Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania |
| title_full | Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania |
| title_fullStr | Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania |
| title_full_unstemmed | Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania |
| title_short | Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania |
| title_sort | anthropometric measurements can identify small for gestational age newborns a cohort study in rural tanzania |
| topic | Small for gestational age Foot length Chest circumference Mid upper arm circumference Gestational age Africa |
| url | http://link.springer.com/article/10.1186/s12887-019-1500-0 |
| work_keys_str_mv | AT ceciliebøgepaulsen anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT birgittebruunnielsen anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT omariabdulmsemo anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT sofielykkemøller anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT josephinerothekmann anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT thorgrundtvigtheander anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT ibchristianbygbjerg anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT johnpeterandrealusingu anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT danielthomasremiasminja anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania AT christentzeschmiegelow anthropometricmeasurementscanidentifysmallforgestationalagenewbornsacohortstudyinruraltanzania |