Nutritional Status Of Newborns Research Articles

Comparative Assessment of Fetal Malnutrition Using the Clinical Assessment of Nutritional Score and Anthropometry Among Newborns Delivered at Debre Markos Comprehensive Specialized Hospital, Ethiopia

Background Fetal malnutrition (FM) is inability to gain a sufficient amount of muscle mass and stoutness during prenatal growth. It has both immediate and long-term effects in early neonatal and late adulthood. Objectives The aim of this study was to assess FM incidence using clinical nutritional assessment (CAN) score and evaluate CAN score with anthropometry to develop simple and reliable screening algorithm. Methods Institution-based study was carried out at Debre Markos Comprehensive Specialized Hospital (DMCSH). Only term singleton newborns were measured for weight, head circumference (HC), crown-heel length, and midarm circumference (MAC). Ponderal index (PI), body mass index (BMI), and MAC to HC ratio were computed. Nutritional status of newborns was evaluated using CAN score within 24 hours of delivery. Stata version 14 software was used for data analysis. Results In this study, 422 term newborns were participated. FM incidence was 13.74% by CAN score. About 15.40, 13.03, and 7.58% of malnourished newborns were identified through MAC/HC, BMI, and PI, respectively. Sensitivities of PI, MAC to HC, and BMI were 48.28, 81.03, and 86.21%, respectively. Specificities of PI, BMI, and MAC to HC were 98.90, 98.63, and 95.05%, respectively. Conclusions Almost one in every seven newborns had FM by the CAN score. The BMI had greatest sensitivity, while the PI exhibited highest specificity in detecting FM. Therefore, birth attendants lacking training in CAN score can rapidly assess FM using a combination of BMI and PI.

Evaluating the Role of Placental Alkaline Phosphatase in Preterm Labor: Correlations with Gestational Age, Placental Maturity, and Newborn Nutrition

Preterm labor, one of the common pathological phenomena during pregnancy, necessitates prompt and accurate detection to safeguard the health of both pregnant women and newborns. This study focused on placental alkaline phosphatase, a pregnancy-specific enzyme, and its potential role in identifying preterm labor. This study aimed to investigate the relationship between placental alkaline phosphatase, placental maturity, the nutritional status of newborns, and its utility in evaluating preterm labor. A total of 85 pregnant women with singleton pregnancy of more than 15 weeks of gestation admitted to our hospital from March 2022 to May 2023 were selected as study subjects. Our study revealed a positive correlation between PLAP levels and both gestational age and placental maturity (P < 0.05). Our findings indicated that with an increase in gestational age and placental maturity, there was a corresponding increase in placental alkaline phosphatase levels. However, there were no differences in placental alkaline phosphatase between pregnant women of Grade III and Grade II in terms of placental maturity (P > 0.05). There was a significant increase in placental alkaline phosphatase levels among pregnant women who gave birth prematurely (P < 0.05). The receiver operating characteristic curve showed that placental alkaline phosphatase had an excellent effect on the evaluation of preterm labor (P < 0.05). However, there were no significant differences in placental alkaline phosphatase between the pregnant women with and without postpartum complications (P > 0.05). Lastly, placental alkaline phosphatase was found to have an inverse relationship with levels of neonatal albumin and transferrin levels (P < 0.05).

\u201cINTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes\u201d

BackgroundGestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.MethodsThis retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.ResultsTwo hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).ConclusionsIn pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st.

Sistematic Review: Relationship between Pregnant Women Weight, Fetal Weight, Age at Pregnancy, Gravida Status with Birth Weight

Background :
 A person's nutritional condition is influenced by her nutritional status during the womb. In other words, the nutritional status of pregnant women is very influential on their own health and as a predictor of pregnancy outcomes for mothers and nutritional status of newborns (Senbanjo et al, 2013). This is due to fetal food intake can be through the umbilical cord that is connected to the mother's body (Indreswari et al, 2008).
 Various maternal and child health efforts are carried out to reduce mortality. One of them is obstructed fetal growth which must be known while still in utero so that the clinician can be more stringent in monitoring and planning the delivery method to reduce the risk of perinatal death.
 The increase in maternal weight during pregnancy is directly related to the weight of the baby and the risk of giving birth to low birth weight increases with a lack of weight gain during pregnancy. This shows a significant relationship between the increase in body weight of pregnant women and the weight of the baby born. (handayani, 2013). From several studies, it is still not known what factors most influence the birth weight of the baby, so in this study sistematic review was carried out as a strong first step for other researchers in developing this research.
 Method :
 A systematic review through journal reviews of the relationship between maternal weight, fetal weight, age at pregnancy, status of Gravida with birth weight
 Result and Discussion :
 Based on the analysis of the article it was found that the relationship between maternal weight, fetal weight, gestational age, gravida status and birth weight.
 Several studies have reported an increased risk of low birth weight (LBW) among offspring (generally defined as women <20 years). The number of births for women 35 years and over is increasing in both high-income countries and middle-income countries. Several mechanisms have been suggested to explain this. Biological mechanisms for increasing infant birth Low birth weight (LBW) in teenage mothers <20 years can be explained as follows. Blood circulation to the cervix and also to the uterus in adolescents is still not perfect so this can interfere with the process of channeling nutrients from the mother to the fetus she contains. Nutrition of pregnant adolescents also plays a role because adolescents still need nutrients to be shared with the fetus they contain compared to adult pregnant women who do not need nutrients for growth (Johanes, 2009 in Rahardjo et al, 2011).
 Teenage mothers are inherently at risk for birth outcomes that are compromised because biological factors are considered. A large US sample shows that unfavorable birth outcomes for adolescent mothers compared to older mothers occur at several levels due to biological factors (Fraser, Brockert, & Ward, 1995; Chen, et al., 2007). However, additional research shows that this difference does not exist among African-American women because of higher average exposure to social and environmental losses compared to whites (Geronimus, 1987; 1996). This explanation shows that unfavorable birth outcomes among teens compared to older mothers are the norm, from which African American mothers deviate as a result of lower socioeconomic status (SES). The role of social loss in understanding the risks of compromised young mothers from birth outcomes is examined, especially those related to the selection of disadvantaged teenagers to give birth to children. Thus, the way the age of young mothers is associated with unfavorable birth outcomes is considered, both cross and in racial / ethnic groups
 Conclusion : 
 This study has not been able to find a relationship between the weight gain of pregnant women on the weight of the baby born. According to assumptions, this happens because there are still other factors that are not yet known exactly where these factors can affect the weight of the baby born.

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

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.

Different methods for assessment of nutritional status in newborn infants based on physical and anthropometric indexes: a short review article

Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM) and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI) based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN) Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants.

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

ABSTRACT The purpose of this study is to present a report of the experiences of the adoption of the Approach to Nutritional Care during Prenatal and Postpartum Periods, resulting from a partnership between the university and the municipal primary health care system of Santos, SP, Brazil. This approach was developed through joint work plans based on the need to incorporate nutritional care into the prenatal and postpartum care. All stages of design and implementation and the results of this strategy were documented in a field diary. This approach was adopted in two basic health units between 2010 and 2014. The stages of this process were planned in conjunction with health care teams and consisted of putting together interdisciplinary groups for nutrition education during the prenatal period. Interdisciplinary educational group meetings were held focusing on listening to the needs of pregnant women, the provision of prenatal nutritional care, and on the project to monitor the nutritional status of newborns through home visits up to the 15 days of postpartum. The interdisciplinary activities strengthened the bond between the users and the health care team members, contributing to the provision of effective care and promoting integrality. Home visiting contributed to encourage exclusive breastfeeding.

Physical intimate partner violence and low birth weight in newborns from primary health care units of the city of Rio de Janeiro

ABSTRACT Objective To investigate the association between physical intimate partner violence and low birth weight. Methods This cross-sectional study included 604 children with approximately 30 days of age who visited four primary health care units in the city of Rio de Janeiro , Brazil, for the second dose of hepatitis B vaccine. Children with a birth weight below 2.500 g were considered underweight. Information regarding physical intimate partner violence was obtained by the Portuguese version of the Conflict Tactics Scale. The study investigated the 12 months prior to interview. Physical intimate partner violence was analyzed as a dichotomous variable and cumulatively. Associations between physical intimate partner violence and low birth weight were verified by logistic regression models based on crude and adjusted odds ratios and their respective 95% confidence intervals. Results Some (7.1%) babies were born underweight, and 33.6% of the mothers had been exposed to physical intimate partner violence. Physical intimate partner violence was significantly associated with low birth weight (OR=3.69; 95%CI=1.57-8.66). Notably, the odds of low birth weight increase with the severity of violence. Conclusion These findings draw attention to the consequences of physical intimate partner violence on the nutritional status of newborns and emphasize the need of greater attention during prenatal care to improve women's quality of life and to reduce the rate of low birth weight.

A Study to Compare the Nutritional Status Assessed by CAN Score and Ponderal Index against WHO Intrauterine Growth Curves among Newborns at Birth in Selected Hospital of Ambala, Haryana

The neonatal morbidity and mortality is closely related to the nutritional status of newborn at birth and early identification of malnutrition with appropriate tool and technique can reduce the mortality rate. Descriptive and comparative survey design was used to assess and compare the Nutritional status of newborns at birth by CAN Score and Ponderal Index against WHO Intrauterine growth curves at MMIMS&R Hospital, Mullana Ambala. Sixty newborns were selected by purposive sampling from NICU and postnatal wards. The data was collected by Performa for newborn and maternal characteristics, WHO Intrauterine Growth Curves, Ponderal Index and observation sheet of CAN Score. Findings revealed that Ponderal Index (48.4%) classified more newborns as malnourished as compared to CAN Score (25%) with regard to WHO Intrauterine growth curves (21.6%). Ponderal Index has higher Sensitivity (76.9%) and lower Specificity (59.5%) than CAN Score (38.4%, 78.7%) respectively whereas Positive predictive value and Negative predictive value of Ponderal Index (34.4%, 90.3%) was higher than CAN Score (33.3%,82.2%). The likelihood ratio of Positive test of Ponderal Index (1.89) was higher than CAN Score (1.80) and likelihood ratio of Negative test of Ponderal Index (0.38) was lower than CAN Score (0.78) test indicating that Ponderal Index can act more sensitive indicator of assessing malnutrition than CAN Score. The main conclusion of the study is that Ponderal Index may be a simple clinical index but sensitive predictor for identifying malnutrition and for prediction of neonatal morbidity associated with it, without the aid of any sophisticated equipments.

Association between gestational night blindness and serum retinol in mother/newborn pairs in the city of Rio de Janeiro, Brazil

Objective Gestational night blindness (XN) is associated with increased risk of reproductive morbidity and mortality. This study investigated the prevalence of gestational XN among postpartum women treated in a public maternity hospital in the city of Rio de Janeiro, Brazil and evaluated its association with maternal and neonatal (cord blood) serum retinol concentrations. Methods XN was evaluated retrospectively, using an interview according to guidelines of the World Health Organization, in 222 postpartum women (≤6 h after delivery) after singleton births who had low obstetric risk. Serum retinol concentrations were measured according to the modified Bessey method, with a cutoff point lower than 1.05 μmol/L for inadequate serum retinol concentration. Results Prevalence of gestational XN was 18%, and inadequate maternal and cord blood serum retinol concentrations were found in 24.4% and 45.5% of samples, respectively. The results associated gestational XN with inadequate maternal serum retinol concentration ( P = 0.000), and an association was observed between maternal and neonatal serum retinol concentrations ( P = 0.000). A poor association was observed between maternal XN and serum levels of retinol in newborn children ( P = 0.06). Conclusions The results suggest that prevalence of gestational XN and inadequate serum retinol concentration among postpartum women and newborns is a concern, calling attention to the need for studies in other parts of Brazil. In addition, the risk of inadequate serum retinol in newborns was significantly higher among infants of postpartum women with serum retinol levels below 1.05 μmol/L. Gestational XN was associated with inadequate levels of maternal serum retinol, and the results suggest a poor relation between maternal XN and vitamin A nutritional status of newborns.

Suitability of CANSCORE for the assessment of the nutritional status of newborns.

The suitability of Clinical Assessment of Nutritional Status Score (CANSCORE) for the assessment of foetal malnutrition among 372 local Hyderabad newborns was studied. Details of length, weight and body mass index (BMI) at birth were related to total CANSCORE which consisted of scores ranging from 1 to 4 based on the grades of clinical status of hair, cheeks, buttocks, chest, legs, back, neck, arms and skin of anterior abdominal wall. The correlation coefficients of CANSCORE with the length, weight and BMI of newborns indicated that score of hair was least correlated with nutritional status. Normal newborns were found to have the lowest prevalence of foetal malnutrition. In those with retarded measurements of length and weight or BMI, the prevalence of foetal malnutrition was higher. The newborns with retardation of both length and BMI had higher prevalence of foetal malnutrition. The feasibility of the suggested limits of CANSCORE for the foetal malnutrition was assessed. Values of 24 for total CANSCORE and of 22 for "Modified CANSCORE" (score excluding hair as a parameter) were found appropriate for the assessment of foetal malnutrition. Modified CANSCORE is a simple, rapid and quantifiable method for the assessment of foetal malnutrition in term newborns.