Assessment of fetal malnutrition by body mass index and intra uterine growth curves: a comparative study

Abstract

Background: Assessment of fetal malnutrition (FM) is incomplete by intra uterine growth (IUG) charts where only single anthropometric measure like weight is used. Body mass index (BMI) is a weight to length ratio which is a sensitive indicator of malnutrition. This study was aimed at comparing the accuracy of various birth weight based IUG charts with Body mass index of the new-born babies in detection of FM and correlating the neonatal complications with the BMI and the birth weight. Methods: A cohort study was done with a sample of 1192 newborn babies with gestational ages from 34 to 40 weeks. The newborns were classified based on BMI and birth weight after plotting on the BMI charts and various IUG charts. The accuracy of the various IUG charts in identifying FM when compared to BMI was analyzed and correlated with neonatal complications. Results: The prevalence of FM was 26.59% on classifying using BMI charts which was the highest when compared to the IUG charts. The IUG charts misclassified the undernourished babies as well nourished. The incidence of complications was 26.3% among the babies with low BMI when compared to normal BMI (14.8%). The classification of the newborns according to IUG charts did not correlate with incidence of complications. Conclusions: BMI chart is most sensitive indicator of FM at birth and its use is highly recommended in a developing country like India. It helps us to target the under nourished babies, provide better nutritional care and also anticipate and prevent neonatal complications.