Head Circumference And Length As Reliable Anthropometric Indicators For Estimating Gestational Age In Neonates: A Study In The Central Indian Population

  • Ganpat Choudhary
  • Dr. Vimal Modi
  • Dr. Dhiren Kumar Panda
Keywords: Gestational Age, Head Circumference, Crown-Heel Length, Neonates, Anthropometry, Central Indian Population

Abstract

Background: Accurate estimation of gestational age is crucial for neonatal care, particularly in resource-limited settings where advanced diagnostic methods may not be available. This study evaluates the effectiveness of head circumference and crown-heel length as reliable anthropometric indicators for estimating gestational age in neonates from the Central Indian population.

Methods: A cross-sectional study was conducted on 445 healthy neonates born at Index Medical College Hospital & Research Centre, Indore, India. Neonates were categorized into preterm (n = 279) and term (n = 166) groups based on gestational age. Head circumference and crown-heel length were measured within 48 hours of birth. Gestational age was determined using Naegele's formula and corroborated by the New Ballard Score. Pearson correlation coefficients were calculated to assess the relationship between gestational age and the anthropometric measurements. Linear regression models were developed to predict gestational age based on these parameters.

Results: Both head circumference (r = 0.869, p < 0.001) and crown-heel length (r = 0.877, p < 0.001) showed strong positive correlations with gestational age. Regression analysis demonstrated significant predictive power, with R-squared values of 0.756 for head circumference and 0.769 for crown-heel length. Stratified analyses by sex and gestational age categories showed consistent results subgroups, reinforcing the robustness of these models.

Conclusion: Head circumference and crown-heel length are reliable, easily obtainable anthropometric indicators for estimating gestational age in neonates, especially in low-resource settings. Their strong correlation with gestational age and simplicity of measurement make them practical tools for neonatal care, enabling early identification and intervention for at-risk neonates.

Author Biographies

Ganpat Choudhary

Research Scholar, Department of Anatomy, Index Medical College Hospital and Research Centre, Indore, India

Dr. Vimal Modi

Professor and Head, Department of Anatomy, Index Medical College Hospital and Research Centre, Indore, India

Dr. Dhiren Kumar Panda

Assistant Professor, Department of Anatomy, IMS and SUM Hospital, Bhubaneswar, India

References

1. Lee AC, Katz J, Blencowe H, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1(1).
2. March of Dimes, PMNCH, Save the Children, WHO. Born Too Soon: The Global Action Report on Preterm Birth. Geneva: World Health Organization; 2012.
3. Butt K, Lim K. Determination of gestational age by ultrasound. J Obstet Gynaecol Can. 2014;36(2):171-181.
4. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119(3):417-423.
5. Verburg BO, Steegers EA, De Ridder M, Snijders RJ, Smith E, Hofman A, et al. New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol. 2008;31(4):388-396.
6. Olusanya BO, Solanke OA. Perinatal outcomes associated with maternal hypertensive disorders of pregnancy in a developing country. Hypertens Pregnancy. 2012;31(1):120-130.
7. Siza JE. Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in Northern Tanzania. Tanzania Journal of Health Research. 2008;10(1):1-8.
8. Onyiriuka AN. Trends in the incidence of delivery of low birthweight infants in Benin City, Southern Nigeria. Benin Journal of Postgraduate Medicine. 2006;8(1):12-17.
9. Mukherjee S, Chattopadhyay D, Mondal A. Estimation of gestational age from fetal femur length in Eastern Indian population. J Clin Diagn Res. 2014;8(4):01-04.
10. Garbh-Ni Study Group. Approaches to low-cost, simple gestational age estimation. Int J Obstet Gynaecol. 2019;10(2):102-107.
11. Milner KM, Neal EF, Ezzati M, Qureshi Z, Bhutta ZA, Black RE. The use of simple tools to improve outcomes for preterm newborns in resource-poor settings: A review. Pediatrics. 2014;33(1):62-74.
12. El Naggar W, Abdel-Hady H. Anthropometric measurements as a reliable tool for determining gestational age in newborns. Eur J Pediatr. 2015;174(4):453-458.
13. Chrzan-Dętkoś M, Łockiewicz M. Anthropometric measures and their correlation with gestational age in term neonates. PLOS ONE. 2018;13(5).
14. Lubchenco LO, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation. Pediatrics. 1963;32(5):793-800.
15. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013;13:59.
16. Thawani R, Dewan P, Faridi MM, Arora SK, Kumar R. Estimation of gestational age using neonatal anthropometry: A cross-sectional study in India. J Health Popul Nutr. 2013;31(4):523-530.
17. Gandhi D, Masand R, Purohit A. A simple method for assessment of gestational age in neonates using head circumference. Glob J Res Anal. 2014;3(5):211-213.
18. Mukhopadhyay K, Mahajan R, Malhi P, Kumar P. Anthropometric assessment of gestational age in neonates: Comparison of existing methods. Indian Pediatr. 2011;48(5):383-388.
19. Battaglia FC, Lubchenco LO. A practical classification of newborn infants by weight and gestational age. J Pediatr. 1967;71(2):159-163.
20. Kramer MS, McLean FH, Eason EL, Usher RH. Maternal nutrition and spontaneous preterm birth. Am J Epidemiol. 1992;136(5):574-583.
21. Goto E. Meta-analysis of the effectiveness of anthropometric measurements for assessing gestational age in neonates. BMC Pregnancy Childbirth. 2017;17(1):342.
22. Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857-868.
23. Papageorghiou AT, Ohuma EO, Altman DG, Todros T, Ismail LC, Lambert A, et al. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):869-879.
24. Dubowitz LM, Dubowitz V, Goldberg C. Clinical assessment of gestational age in the newborn infant. J Pediatr. 1970;77(1):1-10.
25. Stoll BJ, Hansen NI, Bell EF, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010;126(3):443-456.
26. Ballard JL, Khoury JC, Wedig K, et al. Improved assessment of newborn gestational age in low-resource settings using a modified Ballard Score. Pediatrics. 1997;98(6):947-953.
27. van den Broek NR, Jean-Baptiste R, Neilson JP. Factors associated with preterm, early preterm and late preterm birth in Malawi. PLoS One. 2014;9(3).
28. Kramer MS, Platt R, Yang H, McNamara H, Usher RH. Are all growth-restricted newborns created equal? Pediatrics. 1998;102(2).
29. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. 2006;450:76-85.
30. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75-84.
31. Sharma D, Shastri S, Sharma P. Intrauterine growth restriction: Antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016;10:67-83.
32. Ashtekar S, Lewis J, Phatak A. New fetal growth charts for the Marathwada region of Maharashtra, India. Indian Pediatr. 2007;44(8):621-629.
33. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: When? Where? Why? Lancet. 2005;365(9462):891-900.
34. Maulik D. Fetal growth restriction: the etiology. Clin Obstet Gynecol. 2006;49(2):228-235.
35. Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every Newborn: Progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189-205.
36. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-451.
37. Blencowe H, Cousens S, Chou D, et al. Born Too Soon: The global epidemiology of 15 million preterm births. Reprod Health. 2013;10(Suppl 1).
38. Lawn JE, Kinney M. Preterm Birth: Now the Leading Cause of Child Death Worldwide. Geneva: World Health Organization; 2014.
39. Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384(9940):347-370.
40. Mason E, McDougall L, Lawn JE, Gupta A, Claeson M, Pillay Y, et al. From evidence to action to deliver a healthy start for the next generation. Lancet. 2014;384(9941):455-467.
41. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-2223.
Published
2024-09-19
How to Cite
Ganpat Choudhary, Dr. Vimal Modi, & Dr. Dhiren Kumar Panda. (2024). Head Circumference And Length As Reliable Anthropometric Indicators For Estimating Gestational Age In Neonates: A Study In The Central Indian Population. Revista Electronica De Veterinaria, 25(1), 1528 - 1534. https://doi.org/10.69980/redvet.v25i1.951
Section
Articles