Abstract
BackgroundIn Ghana, 32% of deliveries take place outside a health facility, and birth weight is not measured. Low birth weight (LBW) newborns who are at increased risk of death and disability, are not identified; 13%–14% of newborns in Ghana are LBW. We aimed at determining whether alternative anthropometrics could be used to identify LBW newborns when weighing scales are not available to measure birth weight.MethodsWe studied 973 mother and newborn pairs at the Komfo Anokye Teaching and the Suntreso Government hospitals between November 2011 and October 2012. We used standard techniques to record anthropometric measurements of newborns within 24 hours of birth; low birth weight was defined as birth weight <2.5kg. Pearson's correlation coefficient and the area under the curve were used to determine the best predictors of low birth weight. The sensitivity, specificity and predictive values were reported with 95% confidence intervals at generated cut-off values.ResultsOne-fifth (21.7%) of newborns weighed less than 2.5 kg. Among LBW newborns, the following measurements had the highest correlations with birth weight: chest circumference (r = 0.69), mid-upper arm circumference (r = 0.68) and calf circumference (r = 0.66); the areas under the curves of these three measurements demonstrated the highest accuracy in determining LBW newborns. Chest, mid-upper arm and calf circumferences at cut-off values of ≤29.8 cm, ≤9.4 cm and ≤9.5 cm respectively, had the best combination of maximum sensitivity, specificity and predictive values for identifying newborns with LBW.ConclusionsAnthropometric measurements, such as the chest circumference, mid-upper arm circumference and calf circumference, offer an opportunity for the identification of and subsequent support for LBW newborns in settings in Ghana, where birth weights are not measured by standardized weighing scales.
Highlights
The Millennium Development Goal 4 - to reduce deaths of children under-five years by two thirds - may be unattainable without halving newborn deaths, which comprise 40% of all under-five deaths globally [1,2,3]
It was explained to parents/guardians that there would be some discomfort to the baby during the anthropometric measurements, and that trained health workers would undertake the measurements in order to minimize discomfort
Of the 117 who were excluded, 5% of mothers did not give consent, 27.4% had congenital malformations, 19.7% had scalp swellings and/or limb injuries, 13.7% were critically ill and receiving oxygen, 17.9% were more than 24 hours old and 16.2% weighed less than 1.0 kg. [Fig. 1]
Summary
The Millennium Development Goal 4 - to reduce deaths of children under-five years by two thirds - may be unattainable without halving newborn deaths, which comprise 40% of all under-five deaths globally [1,2,3]. A major risk factor for neonatal mortality is low birth weight (LBW); a birth weight less than 2500 g. Most of the newborns who die are LBW, and are mostly in rural communities [6]. More than half of these LBW babies die shortly after birth at home [3,7,8], mostly in rural families [9]. In Ghana, 32% of deliveries take place outside a health facility, and birth weight is not measured. Low birth weight (LBW) newborns who are at increased risk of death and disability, are not identified; 13%–14% of newborns in Ghana are LBW. We aimed at determining whether alternative anthropometrics could be used to identify LBW newborns when weighing scales are not available to measure birth weight
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