Detection of Fetal Malnutrition by Clinical Assessment of Nutritional Status Score (CAN Score) at Birth and Its Comparison with other Methods of Determining Intrauterine Growth
Liladhar Kashyap, Rashmi Dwivedi
Department of Paediatric Medicine, Gandhi Medical College Bhopal
Abstract

Objective: Detection of fetal malnutrition by Clinical Assessment of Nutritional status score (CAN score) at birth and its comparison with other methods of determining intrauterine growth.

Methods : A cross-sectional study consisting of 500 singleton full term neonates with no major congenital malformations. They were evaluated at Department of Paediatrics, Hamidia hospital Gandhi medical college, Bhopal. Neonatal Anthropometrical measurements were calculated as per standard procedures. Newborns were classified for weight against gestational age on the basis of Alexander and Associates intrauterine growth curves. Ponderal index (PI) was calculated. CAN score was applied and compared with other methods. All data were statistically analyzed.

Results : CAN score of < 25 identified 72.60% (n=363) of babies as well nourished and 27.40% (n=137) as malnourished out of total 500 full term neonates. On comparing with weight for gestational age, CAN score identified malnutrition in 8.3% of AGA babies and 40.1% of SGA babies were found to be well-nourished. Ponderal index identified malnutrition (PI<2.2) in 27.8% of neonates out of which CAN score detected only 69.06% as fetally malnourished and 30.96% as well nourished. Also 11.35% newborns classified as well nourished (PI>2.2) by applying Ponderal index were found to be malnourished by CAN score. Taking CAN score as gold standard method for detecting fetal malnutrition, the sensitivity and specificity of weight for gestational age were found to be 81.75% and 78.44% respectively and that of Ponderal index 70.07% and 88.15% respectively

Conclusion: CAN score may be a simple clinical index for identifying fetal malnutrition.
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