Assessment by the CANS Score Versus Anthropometry and Impact on Early Neonatal Morbidities

Study Overview
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Brief Summary
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Assessment of malnutrition within 48 hours of birth through anthropometric indices as Weight, Length and Head circumference, Proportionality indices as MAC/HC ratio, Ponderal index and Body mass index, Clinical assessment of nutritional status (CANS) score. Detection of early neonatal morbidities within the first week of life including Hypoglycemia ,Polycythemia, Respiratory Distress Syndrome, Neonatal sepsis, Hyperbilirubinemia and Feeding intolerance

Detailed Description
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Within the 1st 48 hours of birth, all live born, singleton neonates with gestational ages between 28-40 weeks will be included in the study after obtaining an informed consent from their legal guardians. Assessment of malnutrition within 48 hours of birth: Anthropometric indices: Weight (using the infant weighing scale). Length (using the infant measuring board). Head circumference (using non-metallic non-stretchable tape). Proportionality indices: MAC/HC ratio (Calculation for each infant and value will be plotted on and compared with a standard curve). Ponderal index Body mass index Clinical assessment of nutritional status (CANS) score: A total score <25 is considered as fetal malnutrition. 3. Detection of early neonatal morbidities within the first week of life (for those who will require NICU admission): Hypoglycemia (Random blood sugar) Polycythemia (Hematocrit level) Respiratory Distress Syndrome Neonatal sepsis (Clinically, Laboratory: CBC with diff., CRP, C/S) Hyperbilirubinemia (Serum bilirubin level, Need of phototherapy or exchange transfusion) Feeding intolerance (Abdominal distension with prominent intestinal loops, Gastric residue more than 3ml/kg before feeding at least 2 times/ day)

Official Title
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Assessment by the CANS Score Versus Anthropometry and Impact on Early Neonatal Morbidities

Conditions
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Fetal Malnutrition

Intervention / Treatment
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* Diagnostic Test: Clinical assessment of nutritional status (CANS) score
* Diagnostic Test: Anthropometric indices
* Diagnostic Test: Proportionality indices


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Neonates of both genders. Gestational age between 28-40 weeks. Singleton pregnancies. Exclusion Criteria: Presence of congenital anomalies. Infants of diabetic mothers

Ages Eligible for Study
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Maximum Age: 2 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Clinical assessment of nutritional status (CANS) score|Systematized inspection and estimation of loss of SC tissues and muscles of nine superficial physical parameters including hair and buccal fat in the cheeks, chin and neck, arms, back, inter or subscapular skin, buttocks, legs, chest, and abdominal wall skin. These signs will be rated from 1 (worst, severe FM) to 4 (best, well nourished), and the highest and lowest total scores are 36 and 9, 3respectively. A total score of <25 is considered as fetal malnutrition.|
|Diagnostic Test: Anthropometric indices|weight, length and head circumference|
|Diagnostic Test: Proportionality indices|MAC/HC ratio (Calculation for each infant and value will be plotted on and compared with a standard curve). Ponderal index . A PI <2.2 is considered as malnutrition). Body mass index (BMI= weight (kg) / length2 (m). A BMI <11.2 kg/m2 is considered as malnutrition)|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| infant nutritional status | To compare the assessment of infant nutritional status using the CANS score against anthropometric and proportionality indices | Within the 1st 48 hours of birth |