Letters to the Editor

Abstract

Since logistic and operational problems prevent accurate recording of birth weight in India some physicians aimed to identify a simple inexpensive reliable acceptable and easily acceptable parameter to screen LBW infants. During September-October 1991 in India two physicians measured the arm thigh and calf circumference of 400 newborns delivered at NRS Medical College in Calcutta to determine the comparative practical worth of measuring these circumferences in screening low birth weight (LBW) infants. On average the newborns weighed 2.609 kg. 40% weighed less than 2.5 kg. Birth weight was most correlated with birth weight (0.916) followed by calf circumference (0.882) and thigh circumference (0.845) (p < 0.001). Mid-arm circumference contributed 83.9% of the total variance (i.e. coefficient of determination) observed in birth weight. When one added calf circumference the coefficient of determination increased to 86.2% but thigh circumference did not increase it significantly. For newborns weighing 2500 g the regression statistics showed that mid-arm calf and thigh circumference stood at 9.6 10.1 and 15.3 cm respectively. Mid-arm circumference was the most sensitive measurement of LBW (95%) followed by calf circumference (84%) and thigh circumference (80%). Yet calf circumference had the highest specificity (93%) followed by mid-arm circumference (90%) and thigh circumference (86%). The researchers determined that among the three parameters mid-arm circumference was the best parameter for screening LBW infants based on its sensitivity specificity and high coefficient of determination. Paramedical workers can use this inexpensive simple reliable and practicable indicator to record mid-arm circumference to screen for LBW infants which in turn predicts neonatal mortality.