Determination of Fetal Malnutrition in Preterm Newborns

Beatrice Nkolika Ezenwa; Veronica Chinyere Ezeaka; Edna Iroha; Matthias TaiwoChuye Egri-Okwaji

doi:doi:10.11648/j.jfns.20130104.14

| Peer-Reviewed

Determination of Fetal Malnutrition in Preterm Newborns

Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka, Edna Iroha, Matthias TaiwoChuye Egri-Okwaji

Published in Journal of Food and Nutrition Sciences (Volume 1, Issue 4)

Received: 9 October 2013 Accepted: Published: 20 November 2013

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length3 (cm) X100. A PI <2.2 was considered as malnutrition.The MAC/HC ratio was calculated for each infant and value plotted on and compared with a standard curve. Clinical assessment of nutritional status score (CANSCORE) consisted of inspection and estimation of loss of subcutaneous tissues and muscles in the designated areas. A maximum score of 4 was awarded to each parameter with no evidence of malnutrition, and the lowest score of 1 was awarded to parameter with the worst evidence of malnutrition. Fetal malnutrition was defined as CANSCORE less than 25. Statistical analysis was done using the Epi info statistics software version 3.5.1.Results:One hundred and forty preterm newborns were assessed.One hundred and eight (77%) of them were of LBW. CANSCORE identified 34.3% of the babies as FM while PI, MAC/HC and birth weight identified 30.7%, 12.1 and 3.6% of the babies, respectively, as FM. The mean CANSCORE and anthropometry between males and females were not significantly different (p >0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.

Published in	Journal of Food and Nutrition Sciences (Volume 1, Issue 4)
DOI	10.11648/j.jfns.20130104.14
Page(s)	50-56
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Preterm, CANSCORE, Anthropometry, Newborns

References

[1]	Collins Thesaurus of the English Language 2nd Ed. Harper Collins Publishers, 2002.
[2]	Scott K.E, Usher R.H. Fetal malnutrition: Its incidence causes and effects. Am J ObstetGynaecol 1966; 94: 951-963.
[3]	Neel N.R, Alvarez J.O. Risk factors of fetal malnutrition in a group of Guatemalan mothers and neonates. Boletin de la Oficina Sanitaria Panamericana Pan American Sanitary Bureau, 1991; 110: 93-107.
[4]	Alexandra S. Fetal development. In: Human-biology encyclopedia. http://www.biologyreference.com/Epi-Fl/fetaldevelopment-human.html. Accessed 4.20A.m May 31,2010.
[5]	Adebami O.J, Owa J.A, Oyedeji G.A, Oyelami A.O. Prevalence and problems of fetal malnutrition in term babies at Wesley Guild Hospital Southwest Nigeria. West Afr J Med, 2007; 26: 4; 278-282.
[6]	A, Özlem T, Murat Y, Şule Y, Gülsevin T. Fetal malnutrition and its impacts on neonatal outcome in preterm infants. Turkish J Pediatr 2011; 53: 261 – 268.
[7]	Black ER, Lindsay HA, Zulfiquar AB, Caufield LE, de Onis M, Colin M. Maternal and child under-nutrition: Global and regional exposures and health consequences. The Lancet 2008; 37: 243 – 260.
[8]	Chamberlain R, Davey A. Physical growth in twins, post-mature and small for dates children. Arch Dis Child 1975; 50:437-441.
[9]	Miller HC. Intrauterine growth retardation: an unmet challenge. Am J Dis Child 1981; 135: 944-8.
[10]	Wenick M, Noble A. Cellular response in rats during malnutrition at various stages. J Nutr 1966; 89: 300-306.
[11]	Metcoff J. Clinical assessment of nutritional status at birth. Fetal malnutrition and SGA are not synonymous. PediatrClin North Am 1994; 41:875-891.
[12]	Barker DJP, Gluckman PD, Godfrey KM, Harding JE Owens JA, Robinson JS. Fetal nutrition and cardiovascular disease in adult life. The Lancet 1993; 341: 938 - 941.
[13]	Baker DJP. Fetal origins of coronary heart disease. Br Heart J 1993; 69: 195-196.
[14]	Latha N, Nair MKC, Chacko DS. Markers of fetal onset adult diseases. Review article. Indian Pediatr 2009; 46: 548-554.
[15]	Adebami O.J, Owa J.A. Comparison between CANSCORE and other anthropometric indicators in fetal malnutrition. Indian J Paediatr 2008; 75:439-442.
[16]	Naveen S, Vijay K.S, Surinder S. Detection of fetal malnutrition using CANSCORE. Indian J Pediatr 2009; 76: 903-906.
[17]	Damir R. Gestational age - the most important factor of neonatal ponderal index. Yonsei Med J 2004; 45: 273-280.
[18]	Sasanow S.R, Georgieff M.K, Pereira G.K. Mid-arm circumference and Mid-arm circumference over Head circumference ratio: Standard curves for Anthropometric assessment of Neonatal Nutritional status. J Pediatr 1986; 109: 311-315.
[19]	Eregie CO. Arm/head ratio in the nutritional evaluation of newborn infants: a report of an African population. Ann Trop Paediatr 1992; 12: 195-202.
[20]	Olowe SA. Standards of intrauterine growth for an African population at sea level. J Pediatr 1981; 99: 489-495.
[21]	Georgieff MK, Sasanow SR, Mammal MC, Pereira GR. Mid-arm circumference/head circumference ratio for identification of symptomatic LGA, AGA, and SGA newborn infants. J Pediatr 1986; 109: 316-321.
[22]	Eregie C.O. Mid-arm circumference/head circumference ratio: An intrauterine growth standard for the assessment of nutritional status in Nigerian newborn infants. A dissertation submitted to the National Postgraduate Medical College of Nigeria in partial fulfillment of the requirement for the fellowship of the college. Nov 1988.
[23]	Eregie CO. Neonatal nutritional assessment by a method independent of precise maturity determination. J Trop Pediatr 1998; 44: 25-27.
[24]	Adebami O.J. The incidence and problems of fetal malnutrition in term babies at Wesley Guild Hospital Ilesa, Southwest Nigeria. A dissertation submitted to the West African College of Physician in part fulfillment of the requirement for the award of the Fellowship of the College in the faculty of Paediatrics. Oct 2004.
[25]	Lechtig A. Predicting risk of delivering LBW babies: which indicator is better? J Trop Pediatr 1988; 34: 34-41.
[26]	Nkanginieme K.E, Nte A.R. Preventive Paediatrics. In: Azubike JC and Nkanginieme K (Editors) Paediatrics and Child Health in a Tropical Region.2nd ed. African Educational Services, Owerri 2007: 17-27.
[27]	Anderson MS, Hay WW Jr. Intrauterine growth restriction and the small for gestational age infant. In: Avery GB, Fletcher MS, MacDonald MG, eds. Neonatology. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins 2006.
[28]	Hussain K, Aynsley-Green A. The effect of prematurity and intrauterine growth restriction on glucose metabolism in the newborn. NeoReviews 2004; 5: e365-e368.
[29]	Kashyap L, Dwivedi R. Detection of fetal malnutrition by CANSCORE at birth and its comparison with other methods of determining intrauterine growth. PediatricOncall 2006; 1: 3-5.
[30]	Larry NC. Intrauterine and extrauterine recognition and management of deviant fetal growth. In: Symposium on the Newborn. PediatrClin North Am 1977: 24: 431-455.
[31]	Lubchenco LO, Hansman C, Boyd E. Intrauterine growth in length and head circumference as estimated from live birth at gestational ages from 26 to 42 weeks. Pediatr 1966; 37: 403-408.
[32]	McCrabb J, Egan AR; Hosking BJ. Maternal under-nutrition during mid-pregnancy in sheep. Placental size and its relationship to calcium transfer during late pregnancy. Br J Nutr 1991; 65: 157-168.
[33]	Owens JA. Endocrine and substrate control of fetal growth: placental and maternal influences and insulin-like growth factors. ReprodFertilDev1990, 3: 501-517.
[34]	Cetin I, Corbetta C, SereniLPl. Umbilical amino acid concentration in normal and growth retarded fetuses sampled in-utero by cordocentesis. Am J ObstetGynecol 1990; 162: 253-261.
[35]	Orbak Z, Tan H, Sagsoz N, Zor F. The assessment of anthropometrical measurements of newborns and the incidence of fetal malnutrition in Erzurum region. Tr J Med Sciences 1999; 29: 47-50.
[36]	Taciana D, Marilia C. Weight/length ratio: is it a good index to assess the nutritional status of full-term newborns? Jornal de Pediatria 2002; 78: 219-224.
[37]	Mehta S, Anita T, Tarum D, Sudarsharo K, Saroj K. Clinical assessment of nutritional status at birth. Indian Pediatr 1998; 35: 423-428.
[38]	Sardesai VM. Nutrition and development. In: Introduction to clinical nutrition. Marcel Dekker Inc. New York 2010; 2nded: 273 – 282.

Cite This Article

Plain Text BibTeX RIS

APA Style

Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka, Edna Iroha, Matthias TaiwoChuye Egri-Okwaji. (2013). Determination of Fetal Malnutrition in Preterm Newborns. Journal of Food and Nutrition Sciences, 1(4), 50-56. https://doi.org/10.11648/j.jfns.20130104.14

Copy | Download

ACS Style

Beatrice Nkolika Ezenwa; Veronica Chinyere Ezeaka; Edna Iroha; Matthias TaiwoChuye Egri-Okwaji. Determination of Fetal Malnutrition in Preterm Newborns. J. Food Nutr. Sci. 2013, 1(4), 50-56. doi: 10.11648/j.jfns.20130104.14

Copy | Download

AMA Style

Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka, Edna Iroha, Matthias TaiwoChuye Egri-Okwaji. Determination of Fetal Malnutrition in Preterm Newborns. J Food Nutr Sci. 2013;1(4):50-56. doi: 10.11648/j.jfns.20130104.14

Copy | Download

@article{10.11648/j.jfns.20130104.14,
  author = {Beatrice Nkolika Ezenwa and Veronica Chinyere Ezeaka and Edna Iroha and Matthias TaiwoChuye Egri-Okwaji},
  title = {Determination of Fetal Malnutrition in Preterm Newborns},
  journal = {Journal of Food and Nutrition Sciences},
  volume = {1},
  number = {4},
  pages = {50-56},
  doi = {10.11648/j.jfns.20130104.14},
  url = {https://doi.org/10.11648/j.jfns.20130104.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfns.20130104.14},
  abstract = {Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length3 (cm) X100. A PI 0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.},
 year = {2013}
}

Copy | Download

TY  - JOUR
T1  - Determination of Fetal Malnutrition in Preterm Newborns
AU  - Beatrice Nkolika Ezenwa
AU  - Veronica Chinyere Ezeaka
AU  - Edna Iroha
AU  - Matthias TaiwoChuye Egri-Okwaji
Y1  - 2013/11/20
PY  - 2013
N1  - https://doi.org/10.11648/j.jfns.20130104.14
DO  - 10.11648/j.jfns.20130104.14
T2  - Journal of Food and Nutrition Sciences
JF  - Journal of Food and Nutrition Sciences
JO  - Journal of Food and Nutrition Sciences
SP  - 50
EP  - 56
PB  - Science Publishing Group
SN  - 2330-7293
UR  - https://doi.org/10.11648/j.jfns.20130104.14
AB  - Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length3 (cm) X100. A PI 0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.
VL  - 1
IS  - 4
ER  -

Copy | Download

Author Information

Beatrice Nkolika Ezenwa

Department of Pediatrics, Gold Cross Hospital, 17B Bourdillon Road, Ikoyi, Lagos State, Nigeria
Veronica Chinyere Ezeaka

Department of Pediatrics, Lagos UniversityTeaching Hospital, Lagos State, Nigeria
Edna Iroha

Department of Pediatrics, Lagos UniversityTeaching Hospital, Lagos State, Nigeria
Matthias TaiwoChuye Egri-Okwaji

Department of Pediatrics, Lagos UniversityTeaching Hospital, Lagos State, Nigeria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka, Edna Iroha, Matthias TaiwoChuye Egri-Okwaji. (2013). Determination of Fetal Malnutrition in Preterm Newborns. Journal of Food and Nutrition Sciences, 1(4), 50-56. https://doi.org/10.11648/j.jfns.20130104.14

Copy | Download

ACS Style

Beatrice Nkolika Ezenwa; Veronica Chinyere Ezeaka; Edna Iroha; Matthias TaiwoChuye Egri-Okwaji. Determination of Fetal Malnutrition in Preterm Newborns. J. Food Nutr. Sci. 2013, 1(4), 50-56. doi: 10.11648/j.jfns.20130104.14

Copy | Download

AMA Style

Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka, Edna Iroha, Matthias TaiwoChuye Egri-Okwaji. Determination of Fetal Malnutrition in Preterm Newborns. J Food Nutr Sci. 2013;1(4):50-56. doi: 10.11648/j.jfns.20130104.14

Copy | Download

@article{10.11648/j.jfns.20130104.14,
  author = {Beatrice Nkolika Ezenwa and Veronica Chinyere Ezeaka and Edna Iroha and Matthias TaiwoChuye Egri-Okwaji},
  title = {Determination of Fetal Malnutrition in Preterm Newborns},
  journal = {Journal of Food and Nutrition Sciences},
  volume = {1},
  number = {4},
  pages = {50-56},
  doi = {10.11648/j.jfns.20130104.14},
  url = {https://doi.org/10.11648/j.jfns.20130104.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfns.20130104.14},
  abstract = {Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length3 (cm) X100. A PI 0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.},
 year = {2013}
}

Copy | Download

TY  - JOUR
T1  - Determination of Fetal Malnutrition in Preterm Newborns
AU  - Beatrice Nkolika Ezenwa
AU  - Veronica Chinyere Ezeaka
AU  - Edna Iroha
AU  - Matthias TaiwoChuye Egri-Okwaji
Y1  - 2013/11/20
PY  - 2013
N1  - https://doi.org/10.11648/j.jfns.20130104.14
DO  - 10.11648/j.jfns.20130104.14
T2  - Journal of Food and Nutrition Sciences
JF  - Journal of Food and Nutrition Sciences
JO  - Journal of Food and Nutrition Sciences
SP  - 50
EP  - 56
PB  - Science Publishing Group
SN  - 2330-7293
UR  - https://doi.org/10.11648/j.jfns.20130104.14
AB  - Background: Fetal malnutrition has been associated with an increased risk of neonatal morbidities and mortalities and its proper documentation in a newborn is essential for optimal management of the child.Objective: To determine the nutritional status of preterm newborns at birth using CANSCORE and anthropometry and to compare the relative efficiency of CANSCORE and the anthropometric indices in detecting FM.Methods:The study was carried out on consecutive, singleton, live born babies of ≥28 completed weeks through 36 weeks gestation born at Lagos University Teaching Hospital, Lagos, Nigeria without any major congenital abnormalities or severe perinatal illness. Each infant was examined by the investigator within 48 hours of birth. Birth weights and lengths were recorded for each infant at birth. Using the Oloweintrauterine growth chart, birth weights for gestational age below the 3rd percentile and above the 97th percentile on the chart were taken as small for gestational age and large for gestational age respectively. PI was computed from the formula: PI = weight (g) / length3 (cm) X100. A PI 0.05). Both CANSCORE and PI detected significantly large numbers of FM in the study sample compared with birth weight. All the anthropometric parameters showed low sensitivity in detection of FM (which is the visible wasting or loss of subcutaneous tissues and muscles) but they all had high specificity.Conclusion:FM is still prevalent in our environment even in preterm babies. CANSCORE identified moremalnourished subjects than anthropometry.
VL  - 1
IS  - 4
ER  -

Copy | Download