DefinePK

Abstract

Background: The first 1,000 days of life are critical for growth and neurodevelopment. In India, low birth weight (LBW) remains high (≈30%), with most LBW infants being term intrauterine growth–restricted (IUGR). Birth weight and gestational age alone may not reflect acute nutritional status. The Clinical Assessment of Nutritional (CAN) Score evaluates nine clinical signs of fetal malnutrition (FM), with a score <25 indicating FM.
Objectives: To (1) assess newborn nutritional status by CAN Score within 48 hours of birth and correlate it with gestational age, (2) evaluate associations between CAN Score and neonatal anthropometric indices (weight for gestational age, BMI, Ponderal Index), and (3) determine relationships between CAN Score and maternal factors (prepregnancy BMI, medical conditions).
Methods: In this hospital-based cross-sectional study, 84 singleton newborns ≥34 weeks gestation were enrolled over 18 months. CAN Score, anthropometric measurements (birth weight, length, head circumference, BMI, Ponderal Index), and maternal data (age, parity, BMI, anemia, comorbidities) were collected. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of weight-for-gestational-age, BMI, and Ponderal Index were calculated using CAN Score as gold standard. Associations were tested via chi-square or Fisher’s exact tests (p < 0.05 significant).
Results: CAN Score identified FM in 54/84 (64.3%) newborns, whereas only 33/84 (39.3%) were small for gestational age (SGA). Among appropriate-for-gestational-age (AGA) infants, 27/51 (52.9%) had FM. Sensitivities of BMI and Ponderal Index for FM were both 72.2% (specificity 60.0%); weight-for-gestational-age sensitivity was 50.0% (specificity 60.0%). No significant associations were found between FM and gestational age, maternal age, parity, BMI, anemia, or other medical conditions.
Conclusion: CAN Score detects FM in a greater proportion of newborns than weight-for-gestational-age or anthropometric indices alone. Its routine implementation alongside standard measures may enhance early identification and intervention for at-risk neonates, particularly in settings with high IUGR prevalence