Felix Maria L, Basantes Carmen, Nicola Susana, Hidalgo Susana, Guevara-Ramírez Patricia, Cadena-Ullauri Santiago, Zambrano Ana Karina
Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, Pichincha, Ecuador.
Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito 170129, Pichincha, Ecuador.
Nutrients. 2025 May 12;17(10):1642. doi: 10.3390/nu17101642.
Fetal malnutrition, characterized by inadequate fat and muscle accretion during intrauterine development, has been linked to adverse outcomes, ranging from neonatal complications to long-term developmental and metabolic disorders. Traditionally, growth curves and birth weight have guided the assessment of newborns' nutritional status; however, these measures often do not accurately reflect changes in body composition. This review compares several evaluation methods-CAN score (Metcoff methodology), body mass index (BMI), Ponderal Index (PI), McLaren Index, mid-upper arm circumference (MUAC), and plicometry-to provide suggestions on selecting the most appropriate approach, depending on the healthcare setting and population needs. Findings from multiple international studies indicate that the CAN score and BMI are among the most accurate tools, offering better sensitivity and specificity than traditional anthropometric indicators. The CAN score, based on a clinical observation of fat deposits, skin texture, and muscle tone, has been widely used in Latin America and remains a practical and cost-effective option. Nonetheless, recent research suggests that BMI, mainly when used alongside the PI, may outperform the CAN score in certain contexts. Considering the complexity of fetal nutritional assessments, integrating multiple methods enhances the diagnostic accuracy. Early identification of malnourished newborns is essential for timely intervention and improved long-term outcomes. Standardizing these diagnostic tools globally could advance efforts to reduce neonatal morbidity and mortality by 2030.
胎儿营养不良的特征是在子宫内发育期间脂肪和肌肉积累不足，它与不良后果有关，范围从新生儿并发症到长期发育和代谢紊乱。传统上，生长曲线和出生体重一直指导着对新生儿营养状况的评估；然而，这些指标往往不能准确反映身体成分的变化。本综述比较了几种评估方法——CAN评分（梅特科夫方法）、体重指数（BMI）、 ponderal指数（PI）、麦克拉伦指数、上臂中部周长（MUAC）和皮褶测量法——以便根据医疗环境和人群需求，就选择最合适的方法提供建议。多项国际研究的结果表明，CAN评分和BMI是最准确的工具之一，比传统人体测量指标具有更高的敏感性和特异性。CAN评分基于对脂肪沉积、皮肤质地和肌肉张力的临床观察，已在拉丁美洲广泛使用，并且仍然是一种实用且具有成本效益的选择。尽管如此，最近的研究表明，BMI，主要是与PI一起使用时，在某些情况下可能优于CAN评分。考虑到胎儿营养评估的复杂性，综合多种方法可提高诊断准确性。早期识别营养不良的新生儿对于及时干预和改善长期预后至关重要。在全球范围内标准化这些诊断工具可以推动到2030年降低新生儿发病率和死亡率的努力。
