Study of the prevalence of and high risk factors for fetal malnutrition in term newborns.

This observational study was done to discover the prevalence of fetal malnutrition (FM) in term newborns using clinical assessment of nutritional status (CANS score) and to identify associated risk factors. All term babies born in a referral teaching hospital during the 1-year study period were included in the sample. Gestational age and weight-for-gestational-age were assessed, and babies were classified as appropriate-for-gestational-age (AGA), small-for-gestational-age (SGA) or large-for-gestational-age (LGA). Maternal risk factors were recorded in each case. Fetal malnutrition was present in 19.6% of babies, of whom 40.7% had intrauterine growth retardation. Of the babies with FM, 59.9% were AGA and 1.9% were SGA even though they had no signs of FM. FM was evident in 84.2% of SGA babies, and 12.9% of AGA babies showed FM. The weights of babies with FM were significantly lower than of those without FM. Maternal risk factors for FM included adverse age, primiparity, low pre-pregnancy weight and height, a bad obstetric history and pregnancy-induced hypertension. Malnutrition in the newborn might be missed if intrauterine growth curves only are used for assessment. The CANS score is a simple and rapid clinical scoring system for diagnosing fetal malnutrition. Not all SGA babies are malnourished and those without FM have a better outcome and faster catch-up growth.