Comparison of clinical assessment of nutritional status (CAN) score with other methods in the assessment of fetal malnutrition

Abstract

Background: Assessment of nutritional status of new born has been a major concern to many clinicians because of the potentially serious sequelae of malnutrition on multiple organ system and future health. Various methods have been used to identify malnourished babies as early as possible. The objective of the study was to assess the nutritional status of new born at birth using CAN score and to compare the utility of CAN score with other commonly used measures for defining nutritional status of new borns like weight for gestational age, Ponderal index and Kanawati index.Methods: The present study is a hospital based cross sectional study consisting of 250 singleton full term with no major congenital malformations. Clinical assessment of nutritional status was done on the basis of CAN score and compared with other methods like weight for gestational age, Ponderal index and Kanawati index.Results: Out of 250 babies, CAN score detected 171 (68.4%) babies as malnourished, weight for gestational age at birth detected 150 (60%) babies as AGA and 100 (40%) babies as SGA. Based on Ponderal index and Kanawati index, 154 (61.6%) babies and 140 (56%) babies were malnourished respectively. Using CAN score as the gold standard for identifying fetal malnutrition, the sensitivity and specificity of weight for gestational age at birth were 51% and 21.5%, the sensitivity and specificity of Ponderal index were 69.5% and 55.6% and the sensitivity and specificity of MAC/HC (Kanawati index) were 77.7% and 91.1%.Conclusions: CAN score is a simple, systemic method of identifying fetal malnutrition. This method does not require any sophisticated equipments or laborious calculations and is a good indicator in comparison with other methods of determining fetal malnutrition.