足月新生儿胎儿营养不良评估中营养状况评分与比例指数临床评估的比较研究

Comparative study of Clinical Assessment of Nutritional status score and proportionality indices in the assessment of fetal malnutrition in term newborns.

作者信息

Ezenwa Beatrice Nkolika, Iroha Edna O, Ezeaka Veronica Chinyere, Egri-Okwaji Mathias T C

机构信息

Department of Pediatrics, Neonatal Unit, Lagos University Teaching Hospital, Lagos, Nigeria.

出版信息

Niger Med J. 2016 Mar-Apr;57(2):124-8. doi: 10.4103/0300-1652.182075.

DOI:10.4103/0300-1652.182075

PMID:27226688

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4872490/

Abstract

BACKGROUND

Fetal malnutrition (FM) which describes the underweight/wasting seen in newborns is a significant contributor to perinatal morbidity and mortality and requires proper documentation. The objective of this study was to assess the nutritional status of term newborns at birth using Clinical Assessment of Nutritional (CAN) status score and four other anthropometric indices and to compare the efficiency of CAN score and the anthropometric indices in identifying FM in term newborns.

MATERIALS AND METHODS

The study was conducted on live singleton babies delivered ≥37-42 completed weeks of gestation at the inborn unit of Lagos University Teaching Hospital without major congenital abnormalities or severe perinatal illness. Birth weights and lengths were recorded at birth. Ponderal index (PI), body mass index (BMI), and mid-arm/head circumference (MAC/HC) ratio were calculated and the values were compared with standard curves. The CAN score consisted of inspection and estimation of loss of subcutaneous tissues and muscles. FM was defined as CAN score <25. Data were analyzed using the Statistical Package for Social Sciences statistics software version 17.0.

RESULTS

Two hundred and eighty-two newborns were analyzed. FM was identified in 14.5%, 10.3%, 13.1%, and 2.8% of newborns using CAN score, PI, BMI, and MAC/HC ratio, respectively. Out of the FM babies identified by CAN score, PI, MAC/HC, and BMI identified 19.5%, 12.3%, and 53.7% of them as FM also. BMI was the most sensitive anthropometric index for detecting FM.

CONCLUSION

CAN score is a simple clinical tool for identifying FM and when used in conjunction with BMI will enhance FM detection.

摘要

背景

胎儿营养不良（FM）是指新生儿体重过轻/消瘦，是围产期发病和死亡的重要原因，需要妥善记录。本研究的目的是使用营养临床评估（CAN）状态评分和其他四项人体测量指标评估足月儿出生时的营养状况，并比较CAN评分和人体测量指标在识别足月儿FM方面的效率。

材料与方法

本研究针对在拉各斯大学教学医院产房出生的单胎活产婴儿，这些婴儿妊娠≥37 - 42足周，无重大先天性异常或严重围产期疾病。出生时记录出生体重和身长。计算 ponderal 指数（PI）、体重指数（BMI）和上臂/头围（MAC/HC）比值，并将这些值与标准曲线进行比较。CAN评分包括对皮下组织和肌肉损失的检查和评估。FM定义为CAN评分<25。使用社会科学统计软件包17.0版对数据进行分析。

结果

对282名新生儿进行了分析。分别使用CAN评分、PI、BMI和MAC/HC比值在14.5%、10.3%、13.1%和2.8%的新生儿中识别出FM。在通过CAN评分识别出的FM婴儿中，PI、MAC/HC和BMI也分别将其中19.5%、12.3%和53.7%识别为FM。BMI是检测FM最敏感的人体测量指标。