Assessment of fetal malnutrition by clinical assessment of malnutrition score (can score) – A cross sectional study

Abstract

Background: Fetal malnutrition is defined as failure to acquire adequate amount of fat and muscle during intrauterine life. It is not synonymous with the terms small for gestational age (SGA) and intrauterine growth retardation (IUGR) one may occur without the other irrespective of the specific etiology and is independent of birth weight and gestational age. A simple, practical, clinically applicable scoring system CAN SCORE was developed by Metcoff to differentiate malnutrition from appropriately nourished babies, irrespective of birth weight or AGA/SGA. Material and Methods: This is cross sectional study conducted in 225 neonates in Adichunchanagiri institute of medical sciences, B.G.Nagara, from 01.04.2020 to 01.11.2020. Birth weight was recorded using electronic weighing scale, Crown to heel length was measured using infantometer. Weight was plotted on Growth charts and classified as AGA, SGA and LGA. Clinical assessment of nutritional status was done between 24-48 hours on the basis of CAN score. Proportionality indices like Ponderal Index calculated and compared with CANSCORE. Statistical analysis was carried out using software SPSS version 20. Pearson’s chi-square test (X2) was used to find the association between the categorical variables. Pearson’s correlation coefficient was used to find the correlation between two continuous variables. P-value of < 0.05 was considered as significant. Results: Out of 225 babies, who fulfilled the inclusion criteria, 29 babies were low birth weight, 34 were small for gestational age, ponderal index identified 25 babies as malnourished while CAN score identified 75 babies as malnourished. By Fischer's exact test CAN score and ponderal index are statistically significantly associated with p<0.001. By Chi-square test Weight for age and CAN score are statistically significantly associated with p<0.001. Conclusion: CAN score is a simple, robust and accurate method of identifying fetal malnutrition.