Estimación de la edad gestacional mediante antropometría neonatal en una población residente a gran altitud
Estimation of gestational age by neonatal anthropometry in a high altitude resident population
DOI:
https://doi.org/10.12873/451torres-salinasKeywords:
altitud, neonatologia, antropometria, longitud, gestacion, edad gestacionalAbstract
Background: Gestational age often predicts the prognosis of newborns and in certain cases guides the provision of specific care. However, in populations with a suboptimal prenatal approach, the use of conventional methods is not always possible. On the other hand, the main anthropometric indicator, weight, is lower due to chronic hypoxia; there is a need to evaluate the capacity of other anthropometric measures to estimate gestational age and thus improve the quality of care in this population.
Objectives: To estimate gestational age, using non-standard anthropometric measurements in a hospital located at 3250 meters above sea level in the Peruvian Andes.
Methods: A prospective cross-sectional study was carried out during the period from June to September 2024, including 242 newborns, using arm circumference (AC), thigh circumference (MC), and calf circumference (CC) as anthropometric measurements, using standardized techniques. Standard statistical methods were adopted to determine the critical limit, correlation coefficient and estimation by regression analysis. The outcome indicator was the best regression model.
Results: Anthropometric measurements showed a positive correlation with gestational age up to 37 weeks, after which it began to decrease. A positive correlation was found between the sum of circumferences with gestational age for women and men of: BC+CM+CP (r=0.840), BC+CM+CP (r=0.868); and, the estimation of gestational age in weeks using the formulas: EG= 18.022+ (CM*0.885) + (CP*0902) or EG= 16.79 + (CM*0.894) + (CP*1.008) respectively.
Conclusion: The gestational age of newborns born to mothers living at high altitude can be estimated using anthropometric measurements such as BC, CM, CP; The combination of these being the most effective. Therefore, it is suggested to use them when standard methods are not possible to perform.
References
- Unicef data. Monitoring the situation of children and women [Internet]. 2024 Mar. Available from: https://data.unicef.org/topic/child-survival/neonatal-mortality/#:~:text=The%20first%2028%20days%20of,1%2C000%20live%20births%20in%201990.
- Ávila Vargas-Machuca JG. Inequality in Peruvian neonatal mortality generated by poverty and education, 2011-2019. Rev Peru Med Exp Salud Publica [Internet]. 2022 Jun. 30 [cited 2024 Nov 1]; 39(2):178-84. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/10629
- Aaron O´Neill. Peru: Infant mortality rate from 2011 to 2021 [Internet]. 2024 Mar. Available from: https://www.statista.com/statistics/807105/infant-mortality-in-peru/#statisticContainer
- Stephenson T., Symonds M. Maternal nutrition as a determinant of birth weight. Arch Dis Child Fetal Neonatal Ed. [Internet]. 2002 Jan. [cited 2024 Nov 1]; 86(1), F4–F6. Available from: https://doi.org/10.1136/fn.86.1.f4
- Wubetu A., Amare Y., Haile A., Degu M. Newborn Birth Weight and Associated Factors Among Mother-Neonate Pairs in Public Hospitals, North Wollo, Ethiopia. Pediatric Health Med Ther [Internet]. 2021 Mar 09 [cited 2024 Dic 1]; 12, 111–118. Available from: https://doi.org/10.2147/PHMT.S299202
- Belbasis L., Savvidou M., Kanu C., Evangelou E., Tzoulaki I. Birth weight in relation to health and disease in later life: an umbrella review of systematic reviews and meta-analyses. BMC Med [Internet]. 2016 Sep 28 [cited 2024 Dic 1]; 14(1), 147. Available from: https://doi.org/10.1186/s12916-016-0692-5
- Hendrixson D., Lasowski P., Koroma A., Manary M. Newborn Mid-Upper Arm Circumference Identifies Low-Birth Weight and Vulnerable Infants: A Secondary Analysis. Curr Dev Nutr [Internet]. 2022 Sep 12 [cited 2024 Dic 1]; 6(10), nzac138. Available from: https://doi.org/10.1093/cdn/nzac138
- Sharma J., Saxena S. Sharma U. Standard curves for mid arm circumference and mid-arm/head circumference ratio in newborns. Indian J Pediatr. [Internet]. 1990 May [cited 2024 Nov 1]; 57, 389–393. Available from: https://doi.org/10.1007/BF02727922
- Tiruneh C. Estimation of Gestational Age Using Neonatal Anatomical Anthropometric Parameters in Dessie Referral Hospital, Northeast Ethiopia. Risk Manag Healthc Policy. [Internet]. 2020 Dec 15 [cited 2024 Nov 1]; 13, 3021–3029. Available from: https://doi.org/10.2147/RMHP.S280682
- Ray Yip, Altitude and birth weight, The Journal of Pediatrics, [Internet]. 1987 Dec [cited 2024 Dic 1]; Vol. 111, Issue 6, Part 1, Pag. 869-876. ISSN 0022-3476. Available from: https://doi.org/10.1016/S0022-3476(87)80209-3
- Wang B., Yao Y., Kang, J., Li C., Zhang G., Yu Z. Birth growth curves of neonates in high-altitude areas: A cross-sectional study. Front Pediatr. [Internet]. 2023 Jan 10 [cited 2024 Dic 1]; 10, 1028637. Available from: https://doi.org/10.3389/fped.2022.1028637
- Bailey B., Donnelly M., Bol K., Moore L., Julian C. High Altitude Continues to Reduce Birth Weights in Colorado. Matern Child Health J. [Internet]. 2019 Nov [cited 2024 Dic 4]; 23(11), 1573–1580. Available from: https://doi.org/10.1007/s10995-019-02788-3
- Jumar S., Jain H. A comparative study of calf muscle circumference with other anthropometry measurement as a measure of low birth weight in neonates. Int J Contemp Pediatr. [Internet]. 2020 Mar [cited 2024 Dic 4];7(3):540-545. Available from: https://doi.org/10.18203/2349-3291.ijcp20200677
- Kumar S, Jaiswal K, Dabral M, Dabral M, Malhotra AK, Malhotra AK, et al. Calf circumference at birth: A screening method for detection of low birth weight. Indian J Community Health [Internet]. 2012 Dec 31 [cited 2024 Dic 4];24(4):336-41. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/275
- Bigham A. Genetics of human origin and evolution: high-altitude adaptations. Curr Opin Genet Dev. [Internet]. 2016 Aug [cited 2024 Dic 4]; 41, 8–13. Available from: https://doi.org/10.1016/j.gde.2016.06.018.
- Moore L., Young D., McCullough R., Droma T., Zamudio S. Tibetan protection from intrauterine growth restriction (IUGR) and reproductive loss at high altitude. Am J Hum Biol [Internet]. 2001 Sep-Oct [cited 2024 Nov 4]; 13: 635–644, 2001. Available from: https://doi.org/10.1002/ajhb.1102
- Parraguez V., et.al. Ovine placenta at high altitudes: comparison of animals with different times of adaptation to hypoxic environment. Anim Reprod Sci. [Internet]. 2006 Sep [cited 2024 Dic 4]; 95(1-2), 151–157. Available from: https://doi.org/10.1016/j.anireprosci.2005.11.003
- Gilbert R., Cummings L., Juchau M., Longo L.. Placental diffusing capacity and fetal development in exercising or hypoxic guinea pigs. J Appl Physiol Respir Environ Exerc Physiol. [Internet]. 1979 Apr [cited 2024 Dic 7];46(4):828-34. Available from: https://doi.org/10.1152/jappl.1979.46.4.828
- Rockwell L., Keyes L., Moore L.. Chronic hypoxia diminishes pregnancy-associated DNA synthesis in guinea pig uteroplacental arteries. Placenta. [Internet]. 2000 May [cited 2024 Dic 7];21(4):313-9. Available from: https://doi.org/10.1053/plac.1999.0487
- Matheson H., Veerbeek J., Charnock-Jones D., Burton G., Yung H. Morphological and molecular changes in the murine placenta exposed to normobaric hypoxia throughout pregnancy. J Physiol. [Internet] 2016 Mar [cited 2024 Dic 7];1;594(5):1371-88. Available from: https://doi.org/10.1113/JP271073
- Bailey B., Donnelly M., Bol K., Moore L., Julian C. High Altitude Continues to Reduce Birth Weights in Colorado. Matern Child Health J. [Internet] 2019 Nov [cited 2024 Dic 7];23(11):1573-1580. Available from: https://doi.org/10.1007/s10995-019-02788-3
- Argandoña J., Clasificación del recién nacido según peso al nacer y edad gestacional con curvas de crecimientos intrauterino propias elaboradas en el hospital EsSalud IV Huancayo 1998-2007. [Tesis de pregrado]. Huancayo: Universidad Nacional del Centro del Perú; 2008. Available from: https://repositorio.uncp.edu.pe/bitstream/handle/20.500.12894/3079/Argando%C3%B1a%20Galarza.pdf?sequence=1&isAllowed=y
- López-Reyes L. El embarazo adolescente, adolescente infantil y sus severos impactos en la sociedad peruana. Una tragedia permanente. An. Fac. med. [Internet]. 2023 Dic [citado 2024 Dic 07];84(4):387-390. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832023000400387&lng=es.
- Nureña C. Incorporación del enfoque intercultural en el sistema de salud peruano: la atención del parto vertical. Rev Panam Salud Publica. [Internet]. 2009 [citado 2024 Dic 07];26(4):368–76. Available from: http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892009001000013
- Maguiña C, Galán-Rodas E. Health situation in Peru: the pending agenda. Rev Peru Med Exp Salud Publica [Internet]. 2011 Sep. 30 [cited 2024 Dic 10];28(3). Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/544
- Nur M., Azis N., Tjipta G., Aldy D. Correlation between several anthropometric measurements to birth weight. PI. [Internet]. 2001 Dec 31 [cited 2024 Dic 10];41(11-12):288-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1044
- Kokku P., et.al. Calf circumference to detect low birth weight babies: a comparative study. International Journal of Contemporary Pediatrics. [Internet]. 2019 Dec [cited 2024 Dic 10]; Vol. 6 No. 6. Available from: https://doi.org/10.18203/2349-3291.ijcp20194156
- Mandloi D., Thomas J., Peter P. Correlation of Calf Circumference in Relation to Other Anthropometric Measurements in Low Birth Weight Babies. Research Square. [Internet]. 2023 Mar 27 [cited 2024 Dic 10]. Available from: https://doi.org/10.21203/rs.3.rs-2695880/v1
- Pomeroy E., Stock J., Cole T. O'Callaghan M., Wells J. Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort. PLoS One, [Internet]. 2014 Aug 27 [cited 2024 Dic 10];9(8), e105108. Available from: https://doi.org/10.1371/journal.pone.0105108
- Iannotti L., Zavaleta N., León Z., Caulfield L. Growth and body composition of Peruvian infants in a periurban setting. Food Nutr Bull. [Internet]. 2009 Sep [cited 2024 Dic 10];30(3), 245–253. Available from: https://doi.org/10.1177/156482650903000305
- Taksande A., Vilhekar K., Chaturvedi P., Gupta S., Deshmukh P. Predictor of low birth weight babies by anthropometry. J Trop Pediatr. [Internet]. 2007 Dec [cited 2024 Dic 10];53(6), 420–423. Available from: https://doi.org/10.1093/tropej/fmm052
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