Accuracy of anthropometric measurements in predicting symptomatic SGA and LGA neonates

Abstract

Mid-arm circumference, mid-arm circumference/head circumference ratio, ponderal index and skinfold thickness at five sites (biceps, triceps, quadriceps, subscapular and flank) were measured in 91 small-for-gestational-age (SGA) and 101 large-for-gestational-age (LGA) neonates to investigate their accuracy in identifying neonates at high risk of complications resulting from disturbed intrauterine growth. Thirty-one of 91 SGA and 19 of 101 LGA neonates who developed hypoglycaemia and/or polycythaemia were regarded as symptomatic. Mean values of all of the anthropometric parameters differed significantly between symptomatic and asymptomatic SGA or LGA neonates. The quadriceps skinfold thickness was the most sensitive index in predicting symptomatic SGA and LGA neonates (sensitivity 0.93 and 0.95, respectively). The mid-arm circumference was also a very sensitive index in predicting symptomatic SGA neonates (sensitivity 0.94) but its specificity was extremely low (0.20). The rest of the parameters showed lower sensitivity than quadriceps skinfold thickness associated with similarly low specificity and validity. The findings of this study indicate that the quadriceps skinfold thickness is the most reliable index for use as a screening test for clinical evaluation of SGA and LGA neonates who are likely to develop complications as a result of disturbed intrauterine nutrition.