Anthropometric measurements in a newborn population in west Africa: a reliable and simple tool for the identification of infants at risk for early postnatal morbidity.

The predictive value of anthropometric measurements in the identification of infants at risk for early postnatal morbidity was assessed in a cohort of 490 neonates born in Yaoundé, Cameroon. Mid-arm circumference (MAC), head circumference, weight, and length were measured within 6 hours of birth, and the gestational age, individual MAC/head circumference ratio, and individual ponderal index were calculated. A detailed questionnaire on gestational medical history was also obtained from the mothers. All infants were then closely monitored during the first 72 hours after delivery for the appearance of symptoms requiring medical intervention and treated accordingly. Low birth weight (LBW) was observed in 37.75%, prematurity in 25.5%, and small size for gestational age in 14.1% of the neonates. Gestational medical problems were reported by 44.3% of the mothers; malaria was the most frequent. Early postnatal morbidity was observed in 26% of the infants; infection (53%), respiratory distress (26%), hypoglycemia (26%), and convulsions (11.7%) accounted for most of the problems. The MAC correlated best of all variables with birth weight (r = 0.91); a value of less than or equal to 9.5 cm had a 93% sensitivity and a 90.5% specificity in the prediction of LBW. An MAC cutoff value of less than or equal to 9.5 cm was also the best of all variables in the prediction of early postnatal morbidity, and 85.2% sensitivity and 74.3% specificity were achieved. We conclude that in developing countries, where scales are not always available and the overburdened maternity wards cannot allow for medical surveillance of every infant, the MAC can be used in the estimation of birth weight. Moreover, an appropriately calculated cutoff value of MAC may serve as a reliable indicator of LBW and of infants at risk for early postnatal morbidity.