Study of fetal malnutrition in full-term small for gestational age babies

Abstract

Introduction: Fetal malnutrition (FM) is a risk factor for increased neonatal morbidities and mortalities worldwide. Clinician’s comes across the challenge to identify small for gestational age (SGA) babies whose health is endangered in utero due to a hostile intrauterine environment and to monitor and intervene appropriately. Objectives: This prospective observational study aimed to know the prevalence of FM and to study the occurrence of adverse perinatal events in term SGA babies. Materials and Methods: The study
enrolled 903 term SGA neonates. Clinical assessment of nutrition (CAN) score was applied and anthropometric evaluation was carried out between 24 and 48 h of birth. Babies with adverse perinatal events were treated according to standard hospital protocol. Results: The prevalence of FM in the present study was 34.21% in term SGA babies. All anthropometric parameters such as birth weight, length, head circumference (HC), and ponderal index (PI) were significantly lower in SGA babies with FM as compared to those without FM. There was significantly higher occurrence of FM in SGA babies. Risk of FM was 3.17 times higher in SGA babies with length <3rd centile and risk 2.07 times higher when HC was <3rd centile. The risk of FM was 4.27 times higher when PI <2.2. When PI was compared to CAN score for FM, it had low sensitivity and specificity. Conclusion: CAN score is the better index for the detection of FM and for predicting high risk of perinatal morbidity in term SGA babies. Our study demonstrates that predicting malnutrition is more meaningful than birth weight alone.