Detection of fetal malnutrition at birth using clinical assessment of nutritional status (CAN) score and anthropometric indices and its associated risk factors among term newborns in southern Ethiopia: facility-based cross-sectional study.

OBJECTIVES

This study aimed to determine the prevalence of fetal malnutrition (FM) among term singleton newborns at birth using clinical assessment of nutritional status (CAN) score. The study also compared the CAN score with selected anthropometric indices to describe their ability to identify FM. Furthermore, it sought to identify maternal and neonatal factors linked with FM among term infants delivered in four public hospitals in South Ethiopia.

DESIGN

Cross-sectional study.

SETTING

The study was conducted at four public hospitals in South Ethiopia Regional State.

PARTICIPANTS

480 live-born full-term babies and their mothers delivered at four public hospitals between 6 June 2021 and 19 April 2022.

OUTCOME MEASURES: FM status at birth was the outcome variable. FM was assessed using both the CAN score and selected anthropometric indices. At birth, measurements of height, weight, head circumference (HC) and mid-arm circumference (MAC) were taken. The MAC/HC ratio, body mass index (BMI) and ponderal index (PI) were computed and contrasted with reference curves. By examining and calculating subcutaneous tissue and muscle loss, the CAN score was used to determine the newborn's CAN status. A CAN score of <25 was considered FM.

RESULTS

This study of 480 newborns found varying rates of FM depending on the diagnostic criteria used. The prevalence of FM was highest when assessed by CAN score (26.04%), followed by PI (17.29%), BMI (16.25%), MAC/HC ratio (13.54%) and birth size-for-gestational-age (11.25%). Not attending formal education (AOR 3.31 95% CI 1.14 to 9.64), age between 25-29 years (AOR 2.66 95% CI 1.19 to 5.98), primi-parity (AOR 9.63 95% CI 1.42 to 65.46), having <= two antenatal clinic (ANC) visits (AOR 2.34 95% CI 1.05 to 5.24) and pregnancy-induced hypertension (PIH) (AOR 16.99 95% CI 4.20 to 68.81) were maternal factors significantly associated with increased risk of FM.

CONCLUSIONS

FM was prevalent among term neonates, with the CAN score showing higher prevalence than anthropometric indices. Education level of the mother, primi-parity, fewer ANC visits, maternal age between 25-29 years and PIH were significant risk factors. FM might be most effectively recognised using the CAN score, which can be done without advanced tools.