Assessment of Fetal Malnutrition Based on the CANSCORE Index and Anthropometric Indices

Abstract

Introduction: To prevent the adverse effects of fetal malnutrition (FM), its management and early diagnosis by reliable tools are essential. The present study aimed to identify the rate of malnutrition in a referral maternity center in Iran using different systems for evaluating the nutritional status and determining a better index for FM. Methods: This cross-sectional study was performed on the neonates born in the maternity ward of Hajar Hospital in Shahrekord, Iran in 2020. FM was evaluated based on different parameters, including the CANSCORE index, body mass index (BMI), Ponderal index, and mid-arm circumference/head circumference (MAC/HC) index. After recording the measurements, birth weight and height were plotted on the intrauterine growth chart, and the infants were classified into groups of appropriate for gestational age (AGA), small for gestational age (SGA), and large for gestational age (LGA). Results: Based on the fetal growth status index, 14.7% of the neonates were in the AGA group, and 95.3% were in the LGA group. Malnourishment was detected in 40.5% of the neonates based on the CANSCORE index, 8.3% based on the MAC/HC index, 6.9% based on the BMI, and 5.2% based on the Ponderal index. In addition, the CANSCORE index had a significant positive correlation with all the growth indices (except the MAC/HC index), and the Ponderal index was also significantly correlated with all the growth indices except height. Conclusion: According to the results, the CANSCORE index could show growth status and FM more accurately compared to other anthropometric parameters that may underestimate FM. Furthermore, BMI is a highly sensitive indicator, and infants malnourished in terms of BMI should be examined based on the CANSCORE index to accurately identify FM.

Keywords

• fetal malnutrition
• canscore score
• anthropometric criteria