Comparative Assessment of Fetal Malnutrition Using the Clinical Assessment of Nutritional Score and Anthropometry Among Newborns Delivered at Debre Markos Comprehensive Specialized Hospital, Ethiopia

Abstract

Background Fetal malnutrition (FM) is inability to gain a sufficient amount of muscle mass and stoutness during prenatal growth. It has both immediate and long-term effects in early neonatal and late adulthood. Objectives The aim of this study was to assess FM incidence using clinical nutritional assessment (CAN) score and evaluate CAN score with anthropometry to develop simple and reliable screening algorithm. Methods Institution-based study was carried out at Debre Markos Comprehensive Specialized Hospital (DMCSH). Only term singleton newborns were measured for weight, head circumference (HC), crown-heel length, and midarm circumference (MAC). Ponderal index (PI), body mass index (BMI), and MAC to HC ratio were computed. Nutritional status of newborns was evaluated using CAN score within 24 hours of delivery. Stata version 14 software was used for data analysis. Results In this study, 422 term newborns were participated. FM incidence was 13.74% by CAN score. About 15.40, 13.03, and 7.58% of malnourished newborns were identified through MAC/HC, BMI, and PI, respectively. Sensitivities of PI, MAC to HC, and BMI were 48.28, 81.03, and 86.21%, respectively. Specificities of PI, BMI, and MAC to HC were 98.90, 98.63, and 95.05%, respectively. Conclusions Almost one in every seven newborns had FM by the CAN score. The BMI had greatest sensitivity, while the PI exhibited highest specificity in detecting FM. Therefore, birth attendants lacking training in CAN score can rapidly assess FM using a combination of BMI and PI.