ESPE Abstracts (2018) 89 P-P2-036

Length Estimation Based on Clinical and Anthropometric Measures in Newborns

Martha Beauregard-Paza, America L. Miranda-Loraa, Ana M. Cruz-Hernandeza, Rodolfo Rivas-Rivasb & Miguel Klünder-Klündera

aHospital Infantil de Mexico Federico Gomez, Ciudad de Mexico, Mexico; bCentro Medico Nacional Siglo XXI IMSS, Ciudad de Mexico, Mexico

Background and Aims: The hospitalized neonates requires specialized and multidisciplinary approach and the nutritional follow-up is an essential part of the care. The anthropometry is required to evaluate the nutritional status of patients over time. The main measurements to determine the nutritional status in infants are weight and length. These measures are used to evaluate indexes as length for age, weight for length and body mass index. According to the above, the measurement of length is essential; however, in some patients due to their clinical conditions it is difficult to obtain this measure. In these cases it is necessary to estimate the length through indirect parameters using body segments measures. However, these methods have not proven to be useful in newborns. For all the above, the aim of this study is to identify clinical and anthropometric variables that explain the variability of length in newborns.

Methods: We conducted a cross-sectional study. We obtained sociodemographic and perinatal information of 30 preterm and term newborns at Mexico City public and private hospitals. We also measure weight, length, head circumference and limb measurements (arm span, ulna, tibia and lower leg) with standardized techniques. These data was included in regression models in order to estimate the crown-heel length obtained with an infantometer (gold standard).

Results: A total of 30 neonates were measured (23 term and 7 pre-term), age less than 28 days and equal gender distribution (15 males). According stepwise regression, the best model to predict the crown-heel length includes lower leg length, head circumference and sex (R2=0.85). This equation was better than previously reported equations with a mean difference of 0.004 (95CI −0.31;0.31) vs −8.612 (95CI −9.28;−7.94) and −9.69 (95CI −10.20;−9.18) for Stevenson’s, and −10.95 (95CI −12.11;−9.79) and −13.13 (95CI −14.36;−11.90) for Gauld’s. We observed a little difference between the estimated crown-heel length with this model and the crown-heel length measure (47.6246 cm ±2.09 vs 47.6250 cm ±2.25, P=0.998). The limits of agreement in the Bland-Altman plot were −1.69 to 1.69.

Conclusions: An equation using sex, lower leg length and head circumference is accurate to predict crown-heel length in newborns. This method could be a good tool to estimate the crown-heel length in hospitalized neonates in whom this measurement is not available.

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