Comparative Assessment of Fetal Malnutrition by Anthropometry and CAN Score with associated maternal factors in Sub-District hospital of Uttarakhand

Dr Mamta Nikhurpa,Dr Sandeep Pangty,Dr Vinita Nikhurpa

doi:10.17511/ijpr.2021.i02.03

Dr Mamta Nikhurpa, Dr Sandeep Pangty + Show 1 more

Open Access

https://doi.org/10.17511/ijpr.2021.i02.03

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Abstract

Introduction: Fetal malnutrition is an important contributor to perinatal mortality and morbidity.This study was aimed to assess the nutritional status of the newborn at birth using ClinicalAssessment of Nutrition (CAN score) and compare it with other conventional anthropometric indices.In addition to studying maternal variables associated with fetal malnutrition. Material andMethods: This prospective study was conducted at Sub-District hospital, Uttarakhand for a 3-monthduration from June 2020 to August 2020. Total 765 term, singleton newborn without majorcongenital malformation or comorbidities were included in the study. Anthropometric indices andCAN score were assessed and compared. Results: The incidence of fetal malnutrition was 17.39%using the CAN score. Fetal malnutrition was detected in 133(17.3%), 65(8.5%), 141(18.4%),91(11.8%), 85(11.1%) of newborn using CAN score, PI, Gestational age, BMI, and MAC/HCrespectively. Out of clinically malnourished babies identified by CAN score, PI, gestational age, BMIand MAC/HC identified 49.23% (32), 76.6% (108), 56.04%(51), 49.41%(42) as fetal malnutrition.BMI has the highest sensitivity and diagnostic accuracy for detecting fetal malnutrition. Maternalvariables associated with FM include early maternal age during conception 81.4% (623),primigravida 33.1% (112), anemia (21%), irregular antenatal checkups (40%) and concurrentillnesses (PIH, urinary tract infection, heart disease, renal disease, vascular disease) (50.9%).Conclusion: CAN score is a simple, handy and cost-effective tool to identify FM. Using BMI with CANscore can serve for screening FM. Among maternal variables, primigravida (33.1), anemia (21.5%),irregular antenatal checkup (40.25%), Concurrent medical illnesses (50.96%) is strongly associatedwith FM. Maternal age is not statistically significant.

Highlights

Fetal malnutrition is an important contributor to perinatal mortality and morbidity
This study aims to identify the incidence of fetal malnutrition, to compare different methods of assessment for malnutrition and to study maternal variables associated with fetal malnutrition
Fetal malnutrition is an important contributor to perinatal mortality and morbidity and requires careful observation and documentation for early intervention for intact survival of the newborn.Clinical Assessment of Nutritional Status (CAN) score is a simple, handy and cost-effective tool to detect fetal malnutrition

Summary

Introduction

Fetal malnutrition is an important contributor to perinatal mortality and morbidity. This study was aimed to assess the nutritional status of the newborn at birth using Clinical Assessment of Nutrition (CAN score) and compare it with other conventional anthropometric indices. In addition to studying maternal variables associated with fetal malnutrition. Fetal malnutrition was detected in 133(17.3%), 65(8.5%), 141(18.4%), 91(11.8%), 85(11.1%) of newborn using CAN score, PI, Gestational age, BMI, and MAC/HC respectively. Out of clinically malnourished babies identified by CAN score, PI, gestational age, BMI and MAC/HC identified 49.23% (32), 76.6% (108), 56.04%(51), 49.41%(42) as fetal malnutrition. The global incidence of FM is between 2-10% of total birth especially in underprivileged communities [6] Studies have found that perinatal problems and CNS sequel occurred primarily in those with malnutrition, whether AGA or SGA [3,4,5] Among the contributory maternal variables associated with fetal malnutrition includes poverty, health neglect of females, early age of marriage, poor birth spacing, maternal malnutrition, anemia, infections.

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