Tongo Olukemi O, Ajayi Samuel O, Ogunbosi Babatunde O, Orimadegun Adebola E, Akinyinka Olusegun O
College of Medicine, University of Ibadan, Oyo State, Nigeria.
Paediatr Int Child Health. 2013 Aug;33(3):161-4. doi: 10.1179/2046905513Y.0000000061.
Fetal malnutrition (FM) has grave implications for the neonate and is reliably assessed by the CANSCORE which is time-consuming. Static skinfold thickness, a measure of adiposity, is a validated method of assessing malnutrition in older children.
To establish if static skinfold measurements in neonates can serve as a reliable measure of FM.
To compare static skinfold thickness measurements in neonates using the CANSCORE for the identification of FM.
252 consecutive term neonates delivered at University College Hospital, Ibadan, Nigeria had their CANSCOREs and static skinfold thickness measured within 24 hours of delivery. Using correlation and linear regression analysis, static skinfold thickness cut-off points for FM were determined using a reference CANSCORE of <25.
Prevalence of FM was 20.2% and 26.2% using the CANSCORE and the sum of five skinfold thickness measurements, respectively. The mean (SD) skinfold thicknesses were triceps 3.91 mm (0.74), biceps 2.84 mm (0.55), subscapular 3.79 mm (0.91), supra-iliac 2.64 mm (0.62), quadriceps 4.43 mm (1) and the sum of all measurements 17.61 mm (3.16). All the skinfold thickness measurements correlated significantly with the CANSCORE, but the sum of the five had the best correlation. The quadriceps had the highest specificity of 85.6% and lowest sensitivity of 54.9%, while the sum of all had a sensitivity of 66.7% and specificity of 84.0%.
The sum of all five skinfold measurements might be a useful screening tool for FM in view of its objectivity, convenience and simplicity, but it is not sufficiently sensitive or specific to replace the CANSCORE in the identification of FM in neonates.
胎儿营养不良（FM）对新生儿有严重影响，通过耗时的CANSCORE可对其进行可靠评估。静态皮褶厚度作为肥胖的一种测量指标，是评估大龄儿童营养不良的一种有效方法。
确定新生儿的静态皮褶测量是否可作为胎儿营养不良的可靠指标。
比较使用CANSCORE对新生儿进行静态皮褶厚度测量以识别胎儿营养不良的情况。
在尼日利亚伊巴丹大学学院医院连续分娩的252名足月儿在出生后24小时内测量了CANSCORE和静态皮褶厚度。使用相关性和线性回归分析，以<25的参考CANSCORE确定胎儿营养不良的静态皮褶厚度临界点。
使用CANSCORE和五项皮褶厚度测量值总和时，胎儿营养不良的患病率分别为20.2%和26.2%。平均（标准差）皮褶厚度分别为：肱三头肌3.91毫米（0.74）、肱二头肌2.84毫米（0.55）、肩胛下3.79毫米（0.91）、髂上2.64毫米（0.62）、股四头肌4.43毫米（1），所有测量值总和为17.61毫米（3.16）。所有皮褶厚度测量值与CANSCORE均显著相关，但五项测量值总和的相关性最佳。股四头肌的特异性最高，为85.6%，敏感性最低，为54.9%，而所有测量值总和的敏感性为66.7%，特异性为84.0%。
鉴于五项皮褶测量值总和具有客观性、便利性和简单性，它可能是筛查胎儿营养不良的有用工具，但在识别新生儿胎儿营养不良方面，其敏感性和特异性不足以替代CANSCORE。
