Assessment of Foot Length for Estimation of Small for Gestational Age in Rural Area

Background:
Neonatal period is the most vulnerable for Small for Gestational Age
(SGA) new-borns for survival.About 60% of the new-borns who born term
but have low birth weight due to fetal growth restriction termed as Small
for Gestational Age (SGA). The burden of SGA newborn is very high in
countries of low and middle income and is concentrated high in South
Asia. Identifying these low-birth-weight SGA newborns and referring
them to higher centers for effective interventions would help in
decreasing neonatal mortality and morbidity. Among the anthropometric
measurements, birth weight is the single gold standard for identification
SGA but assessment of accurate BW in rural areas where weight machine
and trained personnel are not available specially in home deliveries,
other simple and easier anthropometric measurement of the newborn
may be as important. Foot length is a screening tool that may be simple
but accurate to identify small new-born in need of extra care in rural
settings of developing country like Bangladesh. Neonatal foot length (FL)
has been proposed as a stable and reliable alternative, as it is less affected
by intrauterine growth restriction (IUGR).
Objective:
To compare mean foot length in term Appropriate for Gestational Age
(AGA) and SGA newborns, to assess the correlation between foot length
and gestational age in both groups and to determine if foot length can
help to differentiate between AGA and SGA infants when GA is
uncertain.
Methods:
This cross-sectional, analytical study was conducted in the Department of
Anatomy, Rangpur Medical College, Rangpur from July 2020 to June 2021
on 200 newborns of both sexes with gestational age between 37 and 42
weeks. The newborn was selected and measured within 24 hours of birth.
100 term newborns weighted<2.5 kg regarAded as SGA were the case and
another 100-term newborns weighted>2.5 kg regarded as AGA served as
control. The birth weight, foot length were measured and a comparison
was done between AGA and SGA newborns. Data was analyzed by using
a statistical package for social sciences (SPSS version 26).
Result:
The mean± SD of birth weight in AGA and SGA groups was
2.99±0.31kg and 2.10±0.24kg respectively, it was observed that the
mean±SD of foot length in AGA group was 8.41±0.74cm and was
7.17±0.81cm in SGA group. Both BW and foot length was significantly
higher in AGA group than SGA group. Again, foot length was
significantly correlated with birth weight in both AGA and SGA groups.
Conclusion:
Foot length of SGA newborns are as effective as birth weight
measurement to predict birth weight in SGA newborns