Crown-heel Length Research Articles

The Association of Infant Birth Sizes and Anemia under Five Years Old: A Population-Based Prospective Cohort Study in China.

Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown-heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28-42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown-heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, -0.008; 95% CI, -0.011--0.004; p < 0.001) and head circumference (β coefficient, -0.004; 95% CI, -0.007--0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown-heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation.

Anthropometric Linear Measurements as Surrogate Marker in Low Birth Weight Infants: A Cross-sectional Study

Introduction: Low Birth Weight (LBW) is linked to perinatal mortality and morbidity, growth, and cognitive developmental defects, along with a greater tendency to develop non communicable diseases later in life. In many settings, the birth weight of infants is not properly noted; weight is either not measured appropriately or tabulated accurately. This has necessitated the use of alternative indices in lieu of birth weight to reliably identify LBW babies, especially in settings where the availability of weighing scales is very limited. Aim: To determine the reliability of anthropometric measurements as a surrogate marker of weight in LBW infants born in a tertiary care hospital. Materials and Methods: This hospital-based cross-sectional study was conducted at Department of Paediatrics and Neonatology, Assam Medical College, Dibrugarh, Assam, India from March 2023 to May 2023. Admitted inborn babies (n=2074) in the postnatal ward and inborn Neonatal Intensive Care Unit (NICU) were included. LBW was defined as &lt;2500 grams. Crown-heel Length (CHL), Chest Circumference (CC), Head Circumference (HC), and Mid-upper Arm Circumference (MUAC) were measured. Student’s t-test and Receiver Operating Characteristic (ROC) curve analysis were used to statistically analyse the data. Results: Out of the 2074 included babies, 1123 were male, and 471 were LBW. The mean birth weight of the LBW cohort was 1.98±0.45 kg compared to 2.78±0.33 kg in the NBW cohort (p-value&lt;0.05). CHL, CC, HC, and MUAC were all significantly lower in the LBW cohort compared to the NBW cohort. MUAC seemed to be the best indicator of LBW. The cut-offs for CHL, HC, CC, and MUAC were 48.5cm, 33.5cm, 30.5cm, and 10.5cm, respectively. Conclusion: The MUAC was strongly correlated with birth weight. MUAC is easy to obtain, simple to perform, and does not require sophisticated equipment.

Assessment of Crown-Heel length, Head Circumference, and Mid-Arm Circumference for Estimation of Small for Gestational Age in Rural Area

Background: The burden of having small for gestational age (SGA) children is high in low- and middle-income countries, mainly in South Asia. Identifying these low birth weight and SGA infants and referring them to higher centers for effective intervention will help reduce neonatal mortality and morbidity. Anthropometric measurements of the neonatal population, especially birth weight measurements, constitute an important scientific research tool for studying the determinants and consequences of impaired or excessive fetal growth. Objective: To find an alternative anthropometric procedure, the present study was done to measure and compare birth weight with crown heel length (CHL), head circumference (HC), and mid-upper arm circumference (MUAC) as predictors of birth weight in small for gestational age (SGA). Methods: This cross-sectional, analytical study was done in the Department of Anatomy, Rangpur Medical College, Rangpur from July 2020 to June 2021 on 200 newborns of both sexes with gestational age between 37 and 42 weeks. The newborn was selected and measured within 24 hours of birth. 100 term newborns weighted &lt;2.5 kg regarded as SGA were the subjects of the study. Another 100-term newborns weighted &gt;2.5 kg regarded as AGA served as control. The birth weight, head circumference, mid-upper arm circumference, and crown heel length were measured and a comparison of all the variables was done between AGA and SGA newborns. Data was analyzed by using a statistical package for social sciences (SPSS version 26). Result: The mean± SD of birth weight in AGA and SGA groups was 2.99 ±0.31 and 2.10±0.24 respectively; it was observed that the mean± SD of crown heel length, head circumference, and mid-upper arm circumference and Ponderal index in AGA group was significantly higher than SGA group; however the MAC/HC ratio was almost similar between AGA and SGA groups. All the above variables were significantly correlated with birth weight in both AGA and SGA groups. Conclusion: Some simple and inexpensive measurements of newborns especially the head circumference of SGA newborns are as effective as birth weight measurement; crown heel length, and mid-upper arm circumference could also be used to predict birth weight in SGA newborns. J Rang Med Col. September 2023; Vol. 8, No. 2: 14-19

Early Metformin in Gestational Diabetes

Gestational diabetes is a common complication of pregnancy and the optimal management is uncertain. To test whether early initiation of metformin reduces insulin initiation or improves fasting hyperglycemia at gestation weeks 32 or 38. Double-blind, placebo-controlled trial conducted in 2 centers in Ireland (one tertiary hospital and one smaller regional hospital). Participants were enrolled from June 2017 through September 2022 and followed up until 12 weeks' postpartum. Participants comprised 510 individuals (535 pregnancies) diagnosed with gestational diabetes based on World Health Organization 2013 criteria. Randomized 1:1 to either placebo or metformin (maximum dose, 2500 mg) in addition to usual care. The primary outcome was a composite of insulin initiation or a fasting glucose level of 5.1 mmol/L or greater at gestation weeks 32 or 38. Among 510 participants (mean age, 34.3 years), 535 pregnancies were randomized. The primary composite outcome was not significantly different between groups and occurred in 150 pregnancies (56.8%) in the metformin group and 167 pregnancies (63.7%) in the placebo group (between-group difference, -6.9% [95% CI, -15.1% to 1.4%]; relative risk, 0.89 [95% CI, 0.78-1.02]; P = .13). Of 6 prespecified secondary maternal outcomes, 3 favored the metformin group, including time to insulin initiation, self-reported capillary glycemic control, and gestational weight gain. Secondary neonatal outcomes differed by group, with smaller neonates (lower mean birth weights, a lower proportion weighing >4 kg, a lower proportion in the >90% percentile, and smaller crown-heel length) in the metformin group without differences in neonatal intensive care needs, respiratory distress requiring respiratory support, jaundice requiring phototherapy, major congenital anomalies, neonatal hypoglycemia, or proportion with 5-minute Apgar scores less than 7. Early treatment with metformin was not superior to placebo for the composite primary outcome. Prespecified secondary outcome data support further investigation of metformin in larger clinical trials. ClinicalTrials.gov Identifier: NCT02980276; EudraCT: 2016-001644-19.

Birth anthropometry among three Asian racial groups in Singapore: proposed new growth charts

ObjectiveWe analysed birth anthropometry of babies of Chinese, Malay and Indian ancestry living in Singapore with an aim to develop gestational age (GA) and gender-specific birth anthropometry charts and compare...

Charts and LMS Tables of Transfontanellar and Transvertical Ear-to-Ear Distances for Gestational Age

IntroductionTo date cranial development has only been described by analyzing occipitofrontal circumference (OFC). More precise methods of determining head measurements have not been widely adopted. The use of additional measurements has the potential to better account for the three-dimensional structure of the head. Our aim was to put forward centile curves of such measurements for gestational age along with a compound head volume index.MethodsWe created generalized additive models for location, scale, and shape of two ear-to-ear distances (EED), transfontanellar (fEED) and transvertical (vEED), from birth anthropometric data. Same was done for OFC, crown-heel length, and birth weight to allow for comparison of our models with growth charts by Voigt et al. and Fenton and Kim.ResultsGrowth charts and tables of LMS parameters for fEED and vEED were derived from 6,610 patients admitted to our NICU and 625 healthy term newborns. With increasing gestational age EEDs increase about half as fast compared to OFC in absolute terms, their relative growths are fairly similar.DiscussionDifferences to the charts by Fenton and Kim are minute. Tape measurements, such as fEED or vEED can be added to routine anthropometry at little extra costs. These charts may be helpful for following and evaluating head sizes and growth of preterm and term infants in three dimensions.

Morphometry of Fetal Liver From Human Fetuses Between 12-36 Weeks Gestational Age.

Background of the studyTo assess the prenatal development of the human liver between 12-36 weeks of gestational age by measuring morphometric parameters using conventional autopsy and to evaluate the morphometric parameters of the human fetus and its liver and their correlation to predict the gestation age.Materials & methodsThe present study was conducted in the Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, India, on 33 normal fetuses of gestational age 12-36 weeks collected from the Department of Obstetrics and Gynecology of the same institute. which were classified into five groups: A (12-16 weeks), B (17-21 weeks), C (22-26 weeks), D (27-31 weeks), and E (32-36 weeks). The parameters measured were liver weight, liver volume, transverse diameter, sagittal diameter, vertical length, length, and width of all four lobes of the liver, i.e., right, left, caudate and quadrate lobe. Also, general morphometric parameters of the fetuses were measured like fetal body weight, crown-rump length, crown-heel length, biparietal diameter, head circumference, chest circumference, abdominal circumference, hand length, foot length, inner inter-canthal distance, outer inter-canthal distance. The obtained data were statistically analyzed using ANOVA, and Pearson’s correlation was assessed.ResultsThere was a statistically significant increase amongst all the fetal general parameters and parameters of liver except bi-parietal diameter, p-value <0.001. The bi-parietal diameter was weakly statistically significant correlated with all other parameters except with chest circumference, crown-heel length, length and width of caudate lobe, and the width of the quadrate lobe and left lobe where it was statistically non-significant.ConclusionBi-parietal diameter is a statistically non-significant parameter to calculate gestation age. The knowledge of morphological features and normal limits of dimensions of the liver with respect to gestational age is a reliable reference to help to prevent misdiagnosis of various pathological conditions of the liver like cirrhosis, hepatomegaly, fetal anemia, intrauterine growth retardation, congenital anomalies like Down's Syndrome, etc.

“ASSESSMENT OF GESTATIONAL AGE BY NEW BALLARD'S SCORE AND ITS CORRELATION WITH FOOT LENGTH”

BACKGROUND – Foot length has been studied by various authors as proxy measurement which can be measured easily in sick and preterm newborns. This study was done to nd the correlation of foot length with gestational age and other anthropometric measurements (birth weight, head circumference and crown heel length). AIMS AND OBJECTIVES1. To study the correlation of foot length and gestational age among the neonates. 2. To study the correlation between foot length and other variables (gestational age, birth weight, head circumference and crown heel length) among the newborns. 3. To study if foot length can be used as a proxy measurement to gestational age and birth weight assessment. MATERIAL: A study sample of 350 live newborns born at MMIMSR, Mullana, Ambala was selected by simple random sampling technique METHODS: Study sample of 350 newborns was selected by simple random sampling technique born at MMIMSR, Mullana, Ambala from April 2020 to May 2021. Babies with limb deformities were excluded from the study group. Babies were grouped into term, preterm and post-term and gestational age was assessed by New Ballard score. These three groups were categorized in to small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) using Fenton growth chart. Correlation of foot length with gestational age and other anthropometric parameters were statistically analysed by correlation and regression analysis. RESULTS- In the study, male newborns were 55.1% and female were 44.9%. Of the 350 newborns, preterms were 32.9%, terms were 65.4% and post-term 1.7%. In the study group, 30.8% were low birth weight babies, 63.4% had birth weight in the range of 2.5- 4 kg and 0.9% had birth weight &gt;4 kg. The mean foot length was 7.301 cm with a range of 4.6-8.4 cms. Foot length correlated signicantly (p &lt; 0.05) with crown heel length, birth weight, gestational age and head circumference in the neonates. Maximum correlation was observed with crown heel length (r = 0.916) which indicates strong positive association between them, followed by birth weight (r = 0.912), gestational age(r = 0.902) and head circumference (r = 0.875). CONCLUSION- Foot length is a easy and reliable anthropometric measurement to assess birth weight and gestational age in neonates, especially who are ill. Foot length can be reliably measured by peripheral heath care workers and could be used effectively for identifying and referring high risk newborns.

Interplay between Maternal and Neonatal Vitamin D Deficiency and Vitamin-D-Related Gene Polymorphism with Neonatal Birth Anthropometry.

Vitamin D deficiency during pregnancy has been associated with poor foetal growth and neonatal birth anthropometry. However, the associations were inconsistent and could be confounded by neonatal vitamin D status and genetic factors. Until recently, limited studies have concomitantly examined the effect of maternal and neonatal vitamin D deficiency and vitamin D-related single nucleotide polymorphisms (SNPs) on neonatal birth anthropometry. This study aims to examine the independent and combined effects of maternal and neonatal vitamin D deficiency and vitamin-D-related SNPs on neonatal birth anthropometry. This cross-sectional study included 217 mother–neonate dyads recruited from Hospital Serdang, Selangor, Malaysia, between 2015 and 2017. Plasma 25-hydroxyvitamin D (25OHD) concentration was measured in maternal and umbilical cord blood using ultra-high-performance liquid chromatography (UHPLC). Maternal and neonatal vitamin D Receptor (VDR) SNP (rs2228570) genotypes were determined using high-resolution melting (HRM). Group-specific component (GC) SNPs (rs4588 and rs7041) genotypes were determined using restriction fragment length polymorphism. Our results showed that: (1) maternal vitamin D deficiency (25OHD < 30 nmol/L) was inversely associated with birth weight, head circumference and crown–heel length; (2) neonatal SNPs, VDR rs2228570 and GC rs4588, were significantly associated with birth weight and head circumference, respectively; and (3) a potential interaction was observed between maternal VDR rs2228570 with maternal vitamin D deficiency on head circumference. These findings suggest that the underlying mechanisms of vitamin D on foetal growth are likely to be localised in the maternal compartment, mediated through the placenta, rather than through cellular mechanisms within the foetus. Further large-scale studies are warranted to validate and extend these findings.

Anthropometric measurements of term babies delivered in a mission hospital in Southwest Nigeria.

Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW). The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW. A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significant P < 0.05 and confident interval of 95%. Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC - 31.89 cm, CC - 29.56 cm, CHL- 43.33 cm and MUAC - 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively. LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.

Morphometric Analysis of Human Fetus and Fetal Pancreas in Different Gestational Age Groups

Introduction: Fetal biometric parameters are very often utilized for calculating gestational age. The pancreas is a gland with dual functions in our body – exocrine and endocrine, with the latter component being very often discussed in the context of diabetes mellitus. Through evaluation of variations in morphometry in relation to different gestational ages, the research intends to draw attention to various associated developmental correlations that were not mentioned in previous studies. Materials and Methods: The current research was carried out on 30 fetuses after obtaining due approval from Institute's Ethical Committee. Fetuses were divided into different gestational age groups and morphometric parameters such as crown-rump length, crown heel length, head circumference, abdomen circumference, chest circumference, hand length, and Foot Length (FL) were noted by measuring with nylon thread in centimetres. Fetal pancreases were removed after stepwise dissection and pancreatic weight along with length and thickness was measured by Vernier calipers. All the parameters were then compared within different gestational age groups. Results: All the parameters and the age group of fetuses were positively correlated and showed statistical significance. Conclusion: The study would add substantial knowledge in the areas of pancreatic regeneration, surgical pancreatectomy, and treatment protocols for diabetes mellitus and pancreatic cancer. Through evaluation of variations in morphometry in relation to different gestational ages, the research intends to draw attention to various associated developmental correlations.

IMPACT OF LIPID-BASED NUTRITIONAL SUPPLEMENTATION IN PRIMI-GRAVIDAS AND ITS EFFECT ON MATERNAL, BIRTH AND INFANT OUTCOMES: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVE: To find out the effect of Lipid based nutritional supplement (LNS) on body composition, hematological findings, maternal, birth and infant outcomes in underweight primi-gravidas. METHODS: This single-blinded randomized controlled clinical trial was executed in the tertiary care hospitals of Khyber Pakhtunkhwa province, Pakistan from April 2018 to August 2019. Forty primi-gravidas recruited in the study were randomized into LNS and placebo groups. LNS group received 75 gms of high energy nutritional supplement, named “MAAMTA”, on daily basis from their first antenatal visit till delivery in addition to their conventional antenatal treatment. Fasting blood samples were taken and body composition was measured at baseline visit, 16th week of gestation and post-natally. For the measurement of hematological parameters neonates cord blood was obtained. Data of 36 participants (LNS group n=19; placebo group n=17) were available for final analysis. RESULTS: Majority (n=33/36; 91.7%) had normal vaginal deliveries (n=18/19 in LNS group &amp; n=15/17 in placebo group). Frequency of Cesarean section was 1/19 (5.3%) in LNS group and 2/17 (11.8%) in placebo group. No case of abortion was reported. Mean crown heel length (CHL) was 47.11±2.747 cm in LNS group and 44.24±2.359 cm in placebo group (p=0.002). Mean fronto-occipital circumference was 35.11±1.663 cm and 32.41±7.859 cm in the LNS and placebo groups respectively (p=0.153). No difference was observed between the groups in maternal gestational weight gain per visit, prevalence of maternal anemia, maternal mortality &amp; neonatal birth weight. CONCLUSION: The prenatal use of LNS increases the CHL of the neonates of underweight primi-gravidas.

Effect of Genetic / Environmental Influence on Growth of Newborn in Himachal Pradesh

Introduction: The effects of altitudinal variation on child growth and development have long been a center of attention for researcher. We believe that hereditary factor primarily affects on child growth and development however environment has secondary effect on it. The available literature on newborns in Himachal Pradesh establishes the fact that as altitude increases the crown heel length decreases. A comprehensive significant finding was also available in both the regions of Himachal Pradesh in terms of head length, foot length, nasal height etc. the comparison between the neonates of the two zones of Himachal Pradesh explains the difference in physical appearance of people of both zones. These features may be biological or behavioral in nature, genetic or developmental in origin. Most instances, a combination of factors are involved. Methods: The present study included 185 parents and their newborns from two zones (Lower zone and Middle zone) of Himachal Pradesh and separated as per the criteria. Measurement of newborn parameters was taken in 12-24 hours after birth by using digital vernier caliper. Ethical clearance from university and permission from Himachal Pradesh government was taken. All the newborns were separated as per criteria 1. Mother / Father from Lower Zone. (Zone category 1) 2. Mother / Father from Middle Zone. (Zone category 2) 3. Mother from Lower Zone / Father from Middle Zone. (Zone category 3) 4. Mother from Middle Zone / Father from Lower Zone. (Zone category 4) Results: Statistically significant difference was obtained in all the four categories. Different parameters were compared across different parent- zone categories by one way ANOVA. The results showed that four parameters shows significantly across groups, viz, Weight, Facial Length, Nasal Height and Philtrum width in all the Zone categories. Conclusions: The early historical studies mention that people living in Himachal Pradesh have migrated from different geographical locations hence their genetics, as well as culture is different from each other. This study clearly demonstrates the effects of environmental factors on child growth and development in Himachal Pradesh. KEY WORD: Anthropometry, Newborn, Himachal, Environment, Genetics.

Association of Maternal Observation and Motivation (MOM) Program with m-Health Support on Maternal and Newborn Health.

Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable women to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and to live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A comparative study was done among 196 pregnant mothers (study group—94; control group—102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb and weight gain and newborn results such as birth weight and crown–heel length were obtained at baseline and at 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity, and maternal well-being. The MOM intervention included initial face-to-face education, three in-person visits, and eight virtual health coaching sessions via WhatsApp. The baseline data on Hb of the mothers show that 31 (32.98%) vs. 27 (28.72%) mothers in the study and control group, respectively, had anemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p < 0.001). The weight gain (p < 0.001), level of physical activity (p < 0.001), and maternal well-being (p < 0.01) also had significant differences after the intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with the consumption of milk (p < 0.001), fruits (p < 0.01), and green vegetables (p < 0.05). As per the physical activity and maternal well-being regression model, the birth weight and crown–heel length were strongly related with the physical activity and maternal well-being of mothers at 36 weeks of gestation (p < 0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers’ human rights.

Maternal Proinflammatory Adipokines Throughout Pregnancy and Neonatal Size and Body Composition: A Prospective Study.

Increased maternal adiposity and inflammation have impacts on fetal growth. The purpose of this prospective study was to investigate the associations of 3 proinflammatory adipokines in pregnancy with neonatal anthropometry. In a sample of 321US pregnant women from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singleton Cohort (NCT00912132), plasma IL-6, fatty acid binding protein-4 (FABP4), and chemerin were measured in plasma samples collected at 10-14, 15-26, 23-31, and 33-39 weeks of gestation. Generalized linear models were used to estimate associations of adipokines with neonatal weight, thigh, and crown-heel length, and skinfolds at birth. Models adjusted for age, race/ethnicity, education, nulliparity, prepregnancy BMI, and weeks of gestation at blood collection. At each time point, higher IL-6 was associated with lower neonatal birthweight and thigh length. At 15-26 weeks of gestation, a 1 SD pg/mL increase in IL-6 was associated with -84.46g lower neonatal birthweight (95% CI: -150.70, -18.22), -0.17cm shorter thigh length (95% CI: -0.27, -0.07), -0.43cm shorter crown-heel length (95% CI: -0.75, -0.10), and -0.75mm smaller sum of skinfolds (95% CI: -1.19, -0.31), with similar associations at 23-31 and 33-39 weeks of gestation. There were no associations of FABP4 and chemerin with neonatal anthropometry. Starting as early as 15 weeks of gestation, higher maternal IL-6 concentrations in pregnancy were associated with lower neonatal birthweight, thigh and crown-heel length, and skinfolds. These data provide insight into the relevance of maternal inflammatory markers with neonatal anthropometry.

Determining Anterior Fontanel Size and Associated Factors Among Term Neonates on the First Day of Life Born at Jimma University Medical Center (JUMC), Southwest Ethiopia: A Linear Regression Model.

BackgroundKnowledge of the normal variation in AF size may be helpful to cue early diagnosis of congenital hypothyroidism, hyperthyroidism, cardiac disease, meningitis, degree of dehydration or provide a clue to disorders of neural and skeletal development. However, the data is scarce. Therefore, this study was aimed to determine AF size and associated factors among term neonates on the first day of life born in Jimma University Medical Center (JUMC), Southwest Ethiopia.MethodologyAn institution-based cross-sectional study design was used to consecutively sample term and health newborns. Descriptive statistics, one-way ANOVA, independent samples t-test and correlation were implemented. Finally, multiple Linear regressions were used to see the association of the dependent and independent variables at 95% confidence interval. The significance level was declared at <0.05 p-value.ResultsThe mean AF size of the study population was 3.018 cm with standard deviation (±SD) of 0.909 cm (range 0.4–5.50cm). A multiple linear regression analysis revealed that neonatal birth weight (B=0.001, 95% CI: 0.000–0.001, p=0.000), crown heel length (B=0.048, 95% CI, 0.018–0.078, p=0.002), labor duration (B= −0.028, p=0.001, 95% CI: −0.45; −0.012), and gender of the neonates (B=−0.275, 95% CI: −.441; −.109, p=0.001) were statistically significantly associated with AF size. In a multiple linear regression analysis AF size was explained by independent variables by 54.3%.ConclusionsAF size of the study population was 3.018 cm with a standard deviation (±SD) of 0.909 cm. Birth weight, crown heel length, duration of labor, and gender of the neonate were significantly associated with AF size.

Prediction of Birth Weight by Using Neonatal Anthropometric Parameters at Birth in Finote Selam Hospital, Ethiopia.

IntroductionBirth weight is an indicator of a newborn’s chances for survival and growth. However, developing countries lack enough weighing scales to identify low birth weight babies. Therefore, finding an alternative to weighing scales is vital.ObjectiveTo predict birth weight from neonatal anthropometric parameters at birth in Finote Selam Hospital, Ethiopia.MethodsA hospital-based cross-sectional study was carried out from July 13 to October 27, 2020. A total of 424 live-delivered neonates were enrolled. Based on eligibility, birth weight and neonatal anthropometric parameters like crown–heel length, foot length, hand length, mid-upper arm circumference, umbilical–nipple distance, intermammary distance and head circumference were measured within 24 hours of birth. The association between birth weight and neonatal anthropometric parameters was evaluated using correlation analysis. Birth weight predictive regression models were formulated by using simple and multiple linear regression analysis.ResultsAll neonatal anthropometric parameters had positive significant correlation with birth weight at p<0.05. Amongst the neonatal anthropometric parameters, the highest significant correlation with birth weight was observed on mid-upper arm circumference (MUAC) followed by foot length (FL), each being r=0.474 and r=0.461, respectively. The best predictive regression models were formulated as birth weight (kg)=0.117+[0.284×MUAC (cm)] and birth weight (kg)=1.137+[0.254×FL (cm)]. As compared to individual neonatal anthropometric parameters, a combination of MUAC, hand length (HL), FL and crown–heel length (CHL) had the highest significant correlation (r=0.661), and a multiple regression equation used to estimate birth weight was formulated as birth weight (kg)=−2.489+[0.192×MUAC(cm)]+[0.078×HL(cm)]+[0.11×FL (cm)]+[0.036×CHL(cm)].ConclusionUsing a combination of MUAC, HL, FL and CHL followed by individual MUAC neonatal anthropometric parameters has high significance to identify low birth weight. Prediction of neonatal birth weight from neonatal anthropometric parameters is crucial to minimize the death of neonates due to low birth weight.

Ontogeny of cranial base during the first two years of life

A total of 32 infants (17 males/15 femeles) having been included in the unexpected infant death french protocol were analyzed. Three-dimensional reconstructions of the cranial base were performed from CT scans. The technique combined manual segmentation of regions of interest, contour extraction and surface reconstruction. Nineteen landmarks were positioned on each of the bone surfaces. No correlation was observed between sex assigned at birth and shape, weight, crown-heel length, or head circumference. Principal component analysis showed that 85.5% of the variance observed on the first component was secondary to growth. After Procrustes superimposition, 25% of the shape variance observed was explained by the first principal component. It showed anteroposterior lengthening of the cranial base. In addition, the height, width and length of the posterior fossa increased and the relative position of the basion was displaced inferiorly and anteriorly with flexion of the sphenoid angle. Negative allometry was also observed. Our study, carried out in a rigorously selected population of infants, presents a fundamental approach to ontogeny through study of shape, growth and ontogenetic allometry.

Correlation of Fractional Limb Volume Measurements with Neonatal Morphometric Indices

Objectives: Fractional thigh volume (TVol) and fractional arm volume (AVol) measurements by three-dimensional (3D) ultrasound can reveal valuable information on fetal soft tissue development. However, it is not clear whether TVol or AVol provides better estimates of fetal body proportion and adiposity, independent of routine two-dimensional (2D) ultrasound biometry. The primary objective of the current study was to determine the correlations between fractional limb volumes (FLVs) and neonatal anthropometric parameters. Design: In this cross-sectional study, fetal FLVs were obtained within 24 h before term delivery from 40 medically and obstetrically uncomplicated pregnancies scheduled for elective cesarean section. TVol and AVol were determined using offline software. Postnatal morphometric data including birth weight; crown-heel, arm, and leg lengths; head, abdominal, mid-thigh, and mid-arm circumferences; and anterior thigh, biceps, and subscapular skinfold thicknesses were obtained. Pearson and partial correlation analyses were used to determine the relationships across antenatal volume calculations and neonatal indices. Correlation coefficients (r) were calculated. Results: Mean maternal age, BMI, and parity were 29.1 ± 5.4 years, 29.7 ± 3.5 kg/m², and 1.0 ± 1.3, respectively. AVol showed moderate correlations with most of the neonatal parameters, including mid-thigh circumference (r = 0.683), mid-arm circumference (r = 0.627), birth weight (r = 0.583), head circumference (HC, r = 0.560), and abdominal circumference (r = 0.542). However, TVol was weakly related to only some of the indices. After controlling for gestational age, maternal age, BMI, parity, and 2D ultrasound biometry, TVol was no longer associated with any of the parameters, while AVol was independently correlated with mid-thigh (r = 0.724) and mid-arm circumference (r = 0.560), birth weight (r = 0.502), ponderal index (r = 0.402), HC (r = 0.382), biceps (r = 0.384), and subscapular skinfold thickness (r = 0.350). Limitations: The current design includes limited number of pregnancies with only scheduled cesarean deliveries. Neonatal percent body fat was not calculated, and air-displacement plethysmography was not used to assess neonatal body composition. The study population was Caucasian with a relatively high maternal BMI, which may limit extrapolation of the results to other settings. Conclusions: AVoL measurements by 3D ultrasound before delivery are significantly correlated with most of the neonatal morphometric indices, independent of maternal characteristics and 2D biometric parameters. AVol may have advantages over TVol for assessing limb soft tissue development in term fetuses. Future research can focus on feasibility and predictive ability of AVol measurements in prospective studies that include serial biometry over time.

Utilization of Foot Length as a Non-Invasive Anthropometric Measurement in Neonates Admitted to the NICU in a Tertiary Care Centre in North Karnataka, India

Background: The majority of the neonates in the Neonatal Intensive Care Unit (NICU) would be on respiratory support either invasive or non-invasive ventilation. Therefore, it is difficult to measure anthropometries, such as weight, length, and head circumference in these sick newborns. This study aimed to determine the correlation of foot length with occipitofrontal head circumference (OFC), crown-heel length (CHL), and weight of the newborn. Methods: A cross-sectional study was conducted at the level IIb NICU of Shri B M Patil Medical College Hospital and Research center, Vijayapur, India. The foot length, OFC, and CHL of the neonates with gestational ages of 28-42 weeks were measured between 12 hours and 7 days of life. Results: Out of 350 neonates enrolled, 61% and 39% of the newborns were preterm and term, respectively. The correlation between foot length and birth weight (r=0.90) and foot length and length (r=0.89) was pronounced in premature neonates. Moreover, a positive linear correlation was observed between foot length and weight in neonates of all gestational ages. To identify the low birth weight (LBW) neonates (<2500 gm), a foot length of less than 7.41 cm had sensitivity and specificity of 94% and 50%, respectively. Furthermore, foot length less than 6.62 cm had 100% sensitivity and 67% specificity to identify the very LBW newborns (<1500 gm). Conclusion: Birth weight and CHL of premature newborns can be estimated from the measurement of foot length that was performed easily and rapidly. Measurement of foot length is valuable in premature neonates who are too ill at birth or those who are on ventilators. Furthermore, foot length may be used in the identification of LBW and VLBW newborns who are admitted to the NICU.