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

Abstract

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 Keywords: Appropriate for gestational age (AGA), Small for gestational age (SGA), Birth weight (BW), Foot length (FL).

J Rang Med Col. 2025 Sep;10(2): 55-59