Designing Colour-coded Measuring Tapes based on Mid-arm and Chest Circumference to Predict Low Birth weight in the Field

Department of Pediatric Medicine, Medical College Kolkata, India.
Journal of Tropical Pediatrics (Impact Factor: 1.26). 11/2011; 57(6):464-7. DOI: 10.1093/tropej/fmr004
Source: PubMed


In developing countries, 80% of the births take place in the community.
Birthweight, mid-arm and chest circumferences were measured in 294 newborns admitted in a tertiary-level hospital in Kolkata between April and August 2010. Colour-coded measuring tapes were devised using receiver operating characteristic curves to calculate the most sensitive and specific cut-off values to identify birthweight <2.5 and 1.8 kg.
There is no significant difference in accuracy of Mid-arm circumference (MAC) and Chest circumference (CC) for prediction of low birth weight and birthweight <1.8 kg. The tape has three zones, green [weight (wt) > 2.5 kg, MAC > 8.4 cm, CC > 30 cm], yellow (wt 2.5-1.8 kg, MAC 8.4-6.7 cm, CC 30-25.5 cm) indicating some risk, and red (wt < 1.8 kg, MAC < 6.7 cm, CC < 25.5 cm) indicating babies needing referral and admission in Level II neonatal care unit.

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    ABSTRACT: Background In Ghana, 32% of deliveries take place outside a health facility, and birth weight is not measured. Low birth weight (LBW) newborns who are at increased risk of death and disability, are not identified; 13%–14% of newborns in Ghana are LBW. We aimed at determining whether alternative anthropometrics could be used to identify LBW newborns when weighing scales are not available to measure birth weight. Methods We studied 973 mother and newborn pairs at the Komfo Anokye Teaching and the Suntreso Government hospitals between November 2011 and October 2012. We used standard techniques to record anthropometric measurements of newborns within 24 hours of birth; low birth weight was defined as birth weight <2.5kg. Pearson's correlation coefficient and the area under the curve were used to determine the best predictors of low birth weight. The sensitivity, specificity and predictive values were reported with 95% confidence intervals at generated cut-off values. Results One-fifth (21.7%) of newborns weighed less than 2.5 kg. Among LBW newborns, the following measurements had the highest correlations with birth weight: chest circumference (r = 0.69), mid-upper arm circumference (r = 0.68) and calf circumference (r = 0.66); the areas under the curves of these three measurements demonstrated the highest accuracy in determining LBW newborns. Chest, mid-upper arm and calf circumferences at cut-off values of ≤29.8 cm, ≤9.4 cm and ≤9.5 cm respectively, had the best combination of maximum sensitivity, specificity and predictive values for identifying newborns with LBW. Conclusions Anthropometric measurements, such as the chest circumference, mid-upper arm circumference and calf circumference, offer an opportunity for the identification of and subsequent support for LBW newborns in settings in Ghana, where birth weights are not measured by standardized weighing scales.
    PLoS ONE 09/2014; 9(9):e106712. DOI:10.1371/journal.pone.0106712 · 3.23 Impact Factor
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    ABSTRACT: Background: The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age. Materials and methods: An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared. Results: 485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96). The optimal cut-points for measurements within 24 h of birth were ≤7.4cm for foot length; ≤30.4cm for chest circumference; and ≤ 9.0cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm). Conclusions: All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable in community settings.
    PLoS ONE 11/2015; 10(11):e0142420. DOI:10.1371/journal.pone.0142420 · 3.23 Impact Factor