Comparative evaluation of calf, thigh and arm circumferences in detecting low birth weight infants--Part II.

In an earlier study usefulness and validity of calf circumference in the identification of low birth weight (LBW) infants was reported. To evolve a simple indicator in identifying LBW in community, comparative evaluation of three simple measurements, i.e., circumferences of calf (CC), thigh (TC) and arm (AC) was done with respect to their sensitivity and specificity. Though all the three measurements showed a high degree of correlation with the birth weight, calf circumference tended to be most sensitive in identifying almost 95% of LBW infants. Having established the superiority of CC, a two color tape demarcating LBW zone from normal birth weight using 10 cm CC as cut off point was tested by two independent investigators and two ANMs. It was observed that only 5% of cases were misclassified either as LBW or normal weight by the tape with hardly any inter individual variation. Measurement of calf circumference being simple and easy even in the hands of paramedics, it would be used as indicator of LBW and neonatal mortality in the community.