title: Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study.
abstract: BACKGROUND
  The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age.
  
  
  METHODS
  An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared.
  
  
  RESULTS
  485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96). The optimal cut-points for measurements within 24 h of birth were ≤ 7.4 cm for foot length; ≤ 30.4 cm for chest circumference; and ≤ 9.0 cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm).
  
  
  CONCLUSIONS
  All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable in community settings.
authors.affiliation: Department of Pediatrics, Hoa Binh General Hospital, Hoa Binh, Vietnam.
authors.forename: Hai Nguyen
authors.initials: HN
authors.lastname: Thi
authors.affiliation: Neonatal Department, National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Dung Khu Thi
authors.initials: DK
authors.lastname: Khanh
authors.affiliation: Neonatal Department, National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: Ha Le Thi
authors.initials: Hle T
authors.lastname: Thu
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Parkville, Australia.
authors.forename: Emma G
authors.initials: EG
authors.lastname: Thomas
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Parkville, Australia.|Department of Paediatrics, The University of Melbourne, Parkville, Australia.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Australia.|Murdoch Childrens Research Institute, Parkville, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Russell
mesh_terms: D000886:Anthropometry; D005006:Ethnicity; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008913:Minority Groups; D014744:Vietnam