DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20213736

A study of correlation of foot length and new Ballard score in determining the gestational age of newborns

Bijli Pathiyil, Anuradha Varadhan, Balachandar B. Varadhan

Abstract


Background: Gestational age (GA) estimation plays a vital role in obstetric, perinatal and neonatal care. Foot length (FL) measurement can serve as a simple, easy and cost effective parameter for estimating GA. The aim of this study was to determine correlation between foot length of new born and GA by new Ballard score and forming a percentile chart if a positive correlation was found.

Methods: GA assessment of newborns born in our hospital was done by new Ballard score within 24 hours of life. FL was measured using vernier caliper. Neonates were classified as pre term, term and post term and also grouped as small for GA (SGA), appropriate for GA (AGA) and large for GA (LGA).

Results: FL measurement was strongly correlating with GA assessment by new Ballard score, with overall correlation coefficient r=0.897 (p<0.001). FL increased as GA increased. Strong positive correlation was seen in pre term and term newborns. The cut-off foot lengths for identifying preterm and early preterm neonates were 73.14 mm (diagnostic accuracy 88.4%) and 68.49 mm (diagnostic accuracy 95.3%), respectively.

Conclusions: Strong positive correlation of foot length with GA by new Ballard score was obtained and a percentile chart of foot length for each GA was formed, with mean and standard deviation. This can serve as a simple and quick tool, requiring less expertise for GA assessment.


Keywords


Newborn, Gestational age, Foot length, New Ballard score, Correlation

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References


Ministry of health and family welfare. Fact sheet: India Newborn Action Plan. New Delhi: Government of India, 2014. [cited 2015 Jan 21]; 29-54. Available at: http://nhm.gov.in/images/pdf/programmes/inap-final.pdf. Accessed on 2 August 2021.

UNICEF. Fact sheet: Every child alive: the urgent need to end newborn deaths. New York: United Nations children’s fund, 2018. Available at: https://www.unicef.org/media/48096/file/Every_Child_Alive_The_urgent_need_to_end_newborn_deaths-ENG.pdf. Accessed on 2 August 2021.

Ministry of Health and Family Welfare. Fact sheet: International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16, 2017. Available at: http://rchiips.org/nfhs/nfhs-4Reports/India.pdf. Accessed on 2 August 2021.

Thawani R, Dewan P, Faridi MMA, Arora SK, Kumar R. Estimation of gestational age, using neonatal anthropometry: a cross-sectional study in India. J Health Popul Nutr. 2013;31(4):523-30.

Fernando DMG, Weerakkody IR, Ranmohottige USN, Gamage SMK, Kumarasiri PVR. Relationship between gestational age, anthropometric parameters of neonates-a preliminary study. Medico Legal J Sri Lanka. 2011;1(1):14-5.

Kramer MS. Determinants of LBW, methodological assessment and meta-analysis. WHO Bull. 1987;65(5):663-737.

WHO, bridging the gaps. The World health report, 1995, Report of the Director General. Available at: https://www.who.int/whr/1995/en/whr95_en.pdf.

Science Open. Fact sheet: OpenEpi: Open-Source Epidemiologic Statistics for Public Health, Version 3.01. Available at: https://www.scienceopen.com/document?vid=61cdd360-9883-4330-8c18-3f0341b0f715. Accessed on 2 August 2021.

Elizabeth KE. Nutrition and Child Development: Normal growth and growth assessment. 5th ed. Hyderabad: Paras Medical Publisher; 2015: 194.

Eichenwald EC, Hansen AR, Martin CR, Stark AR. South Asian Edition of Cloherty and Stark’s Manual of Neonatal care. 8th ed. New Delhi: Wolters Kluwer; 2017: 250-1.

Streeter GL. Weight, sitting height, head size, foot length and menstrual age of the human embryo. Contrib Embryol Carnegie Inst. 1920, 2018. Available at: https://www.worldcat.org/title/weight-sitting-height-head-size-foot-length-and-menstrual-age-of-the-human-embryo/oclc/15517098.

Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D’Alton ME. Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol. 1987;156(2):350-5.

Byers SN. Forensic anthropology laboratory manual: calculation of stature. 4th ed. New York: Routledge; 2017: 224.

Wyk LV, Smith J. Postnatal foot length to determine gestational age: a pilot study. J Trop Pediatr. 2016;62(2):144-51.

Srinivasa S, Manasa G, Madhu GN. Foot length of newborn: its correlation with gestational age and various anthropometric parameters. Curr Pediatr Res. 2017;21(2):248-53.

Gavhane S, Kale A, Golawankar A, Sangle A. Correlation of foot length and gestational maturity in neonates. Int J Contemp Pediatr. 2016;3(3):705-8.

Rakkappan I, Kuppusamy N. Newborn foot length measurement to identify high-risk neonate. Int J Sci Stud. 2016;4(2):13-9.

Kumar V, Tikkas R, Ramteke S, Shrivastava J. Assessment of gestational age using anthropometric parameters: an observational study in India. Int J Pediatr Res. 2017;4(11):672-80.

Thi HN, Khanh DKT, Thu HLT, Thomas EG, Lee KJ, Russell FM. 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. PLoS One. 2015;10(11):0142420.

Srivastava A, Sharma U, Kumar S. To study correlation of foot length and gestational age of newborn by New Ballard score. Int J Res Med Sci. 2015;3(11):3119-22.

Pratinidhi AK, Bagade AC, Kakade SV, Kale HP, Kshirsagar VY, Babar R, et al. Action-oriented colour-coded foot length caliper for primary healthcare workers as a proxy for birth weight and gestational period. Indian J Med Res. 2017;145(3):347-52.

Sateesha SR, Niranjan HS, Jagadish AS, Benakappa N. Correlation of foot and hand length measurement with gestational maturity in neonates. Int J Pharm Bio Sci. 2015;6(3):1050-4.

Saroj AK, Sharma JN, Singh M. Measurement of neonatal foot length to identify low birth weight babies: a cross-sectional hospital based study. IOSR J Dent Med Sci. 2016;6:49-53.

Yadav R, Bhatnagar JP, Gunjan, Verma R, Gupta S, Gupta VK, Bhatia S, et al. Gestational age assessment in newborns using regression equation of anthropometric parameters singly or in combination. Int J Biomed Res. 2016;7(8):600-5.