Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Fetal malnutrition (FM) is a clinical state, characterized by intrauterine loss of or failure to acquire normal amount of fat and muscle mass. Various terminologies used for describing intra uterine malnutrition includes small for gestational age (SGA), intra uterine growth restriction (IUGR) and placental insufficiency. CAN score is a scoring system based on nine ‘superficial’ readily detectable signs of malnutrition in the newborn baby. These includes clinically visible signs of nutritional status in hair, cheeks, neck, arms, chest, abdomen, back but tocks and legs, as developed to differentiate malnourished from appropriately nourished babies. Present study was a cross sectional, observational and analytical study, conducted in post‐natal ward and NICU of department of Pediatrics of Peoples College of Medical Sciences & Research Centre, Bhopal during one and half year (1st December, 2018 to 31st may, 2020) of study period. ‘’To identify the fetal nutritional status by clinical assessment of newborn using CAN score’’. Data was collected within 24‐48 hrs of life of newborn (n = 411) after obtaining written consent from parents. Birth weight was recorded using digital electronic weighing machine, length was measured using infantometer, Head circumference, chest circumference and mid arm circumference was measured using non stretchable measuring tape. Proportionality indices like Kanawati Index (MAC/HC), PI and BMI was calculated for each new born baby and clinical assessment of new born using CAN score (based on superficial physical findings) was done for each newborn. Data was compiled using Microsoft Excel and analyzed using softwares SPSS® Version 20 and MED CALC 19.5. Male to female ratio was 1.12: 1. Fetal malnutrition ( FM ) was found in 18.5% babies as assessed by the CAN score of <25. Out of 411 babies, 76 (18.5%) were with FM (CAN score <25), 23 (5.6%) had MAC/HC ratio <0.25, 56 (13.6%) had Ponderal Index of <2.2, weight for GA was <10th centile in 36 (8.8%) and BMI was <10th centile in 51.09% babies. Weight for GA (p<0.001), MAC/HC (p<0.001), PI (p<0.001), BMI (p<0.001) and length for GA (p<0.001) all were found to have significant association in predicting the fetal malnutrition when CAN score of <25 was taken as the cut off value. Mean value of all anthropometric parameters i.e., birth weight, length, head circumference, chest circumference and mid arm circumference was significantly lower in those with FM as compared to those without FM (p<0.001). In present study, more babies are clustered between CAN score of 27‐29. When modified CAN score cutoff of <27 was considered, 132 (32.1%) babies were found to be malnourished as compared to 76 (18.5%) babies with CAN score cutoff of <25. Also there is strong strength of association (p‐value < 0.001) between modified CAN score cutoff of <27 and variables like weight for GA, PI, BMI and MAC/HC . With modified CAN score cutoff of <27, percentage of FM among AGA babies goes up from 12.26% to 26.66%. Based on the findings of present study it was found that CAN Score is a simple and systematic method to identify FM over and above those babies identified by commonly used anthropometric parameters like weight for GA, length for GA, MAC/HC, BMI and PI. CAN score is a simple method which does not require any sophisticated equipment or time‐consuming calculations. Hence, CAN score can be used as an ideal method for screening malnourished babies in our community.
How to cite this article:
Mohd Asad Khan, Brijesh Kumar Patel, Ankit Yadav and Amit Kumar Singh. To Identify the Fetal Nutritional Status by Clinical Assessment of Newborn Using Can Score.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.324.333
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.324.333