Foot length as a surrogate maker to identify birth weight

Nitesh Upadhyay, Minhajuddin Ahmed


Background: Gestational age and birth weight is an important predicator for morbidity and mortality in neonates. Aim was to determine the correlation of foot length with birth weight and gestational age in neonates.

Methods: This was a prospective observational study done in the neonatal unit department of pediatrics in Chirayu medical college and hospital, Bhopal. There were 1739 deliveries included during the study period from January 2016 to December 2020. Study group comprised of all live born babies delivered in within 24 hours of birth who fulfilled the inclusion criteria.

Results: The study comprised of 1739 newborn babies, out of which 896 (51.51%) were males and 843 (48.49%) were females. Male:female ratio 1.06:1. In our study group, 337 (15.6%) babies were preterm and 1385 (84.39%) were of term gestation. We found a positive linear correlation of foot length with all birth weight groups in a newborn with a correlation coefficient (r=0.78) and p<0.001 was found. Similarly, a positive correlation of foot length and gestational age of newborn in both term and preterm babies with (r=0.83) with p<0.01. Foot length has 87.4% sensitivity and 91.7% specificity among low-birth-weight babies with respect to cut off foot length of 75.5 mm. Foot length has 78.7% sensitivity and 63.7% specificity among preterm babies.

Conclusions: Foot length can be used as a screening tool to identify low birth weight (LBW) and preterm babies as it had a higher sensitivity and specificity.


Foot length, Pre-term, LBW, Newborn

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Huque F, Hussain AM. Detection of low birth weight in newborn babies by anthropometric measurements in Bangladesh. Indian J Pediatr. 1991;58:223-31.

Kumar V, Datta N. Birth weight as an indicator of health. Ind Paediatr. 1984;21:113-8.

Lawn JE, Cousans S, Zupan J. Four million neonatal deaths: When? Where? Why? Lancet. 2005;365(9462):891-900.

United Nations Children`s Fund (UNICEF). The state of world`s Children 2008. New York: UNICEF. 2008. Available at: reports/state-worlds-children-2008. Accessed on 12 June 2021.

United Nations Children`s Fund (UNICEF)/ World Health Organization (WHO). Low Birth weight: Country, Regional and Global Estimates. New York (UNICEF).2004. Available at: https://apps.who. int/iris/handle/10665/43184. Accessed on 21 July 2021.

Committee on nervous System Disorders in Developing Countries (CNSDDC), Board on Global Health Neurological, Psychiatric and Developmental Disorders: Meeting the Challenge in the Developing World. Washington, DC: National Academy Press. 2001.

Mullany LC, Darmstadt GL, Khatry SK, Leclerq SC, Tielsch JM. Relationship between the surrogate anthropometric measurements, foot length and chest circumference and birth weight among newborns of Sarlahi Nepal. Eur J Clin Nutr. 2007;61:40-6.

Singh M, Paul VK, Deorari AD, Anandalakshmi PN, Sundaram KR. Simple tri-coloured measuring tapes for identification of low-birth-weight babies by community health workers. Ann Trop Paediatr. 1988;8:87-91.

Arisoy AE, Sarman G. Chest and mid-arm circumferences: identification of low-birth-weight newborns in Turkey. J Trop Pediatr. 1995;41:34-7.

Ngowi JA, Redding-Lallinger R, Hirji KF. An assessment of the use of anthropometric measures for predicting low birth weight. J Trop Pediatr. 1993;39:356-60.

Monintja HE. Beberapa aspek kebutuhan bayi kurang bulan. In: Suradi R, Monintja H E, Amalia P, Kusumowardhani D, editors. Naskah lengkap pendidikan kedokteran berkelanjutan Ilmu Kesehatan Anak XXXVIII. Jakarta: Balai Penerbit FKUI. 1997;11-44.

Fletcher MA. Physical diagnosis in neonatology. Philadelphia; Lippincott Raven. 1998;29-51.

Sharma JN, Saxena S, Sharma U. Thigh circumference at birth as the best predictor of low-birth-weight babies. Indian J Pediatr. 1989;26:18-21.

Ulijaszek SJ, Kerr DA. Anthropometric measurement error end the assessment of nutritional status. Bri j nutrition. 1999;82:165-77.

Daga SR, Daga AS, Patole S, Kadam S, Mukadam Y. Foot length measurement from foot print for identifying a newborn at risk. J Trop Pediatr. 1988;34(1):16-9.

Hirve SS, Ganatra BR. Foot tape measure for identification of low-birth-weight newborns. Indian Paediatrics. 1993;30:25-9.

Mukherjee S, Roy P, Mitra S, Samant M, Chatterjee S. Measuring new born foot length to identify small babies in need of extra care: a cross-sectional hospital-based study. Iran J Pediatr .2013;23(5):508-12.

James DK, Dryburgh EH, Chiswick ML. Foot length-a new and potentially useful measurement in the neonate. Arch disease childhood. 1979;54:226-30.

Madhulika, Kabra SK, Barar V, Purohit A, Saxena S, Sharma U et al. Upper and lower limb standards in newborns. Indian Pediatric. 1989;26(7):667-70.

Shah SS, Shrestha PS, Gami FC. Detection of low-birth-weight newborns by foot length as proxy measure of birth weight. Arch Dis Child. 2005;90:9-10.

Mathur A, Tak SK, Kothari P. “Foot Length”-a newer approach in neonatal anthropometry. J Trop Pediatrics. 1984;30(6):333-6.

Marchant T. Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital-based study with community follow-up in Tanzania. BMC Public Health. 2010;10:624.

Elizabeth N, Christopher O. Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: A hospital based cross sectional study. BMC Pediatrics. 2013;12:13-54.