Clinical assessment of nutritional status (Cans) in term new borns and its relation to outcome in neonatal period

To study the clinical status of newborn and its relation to outcome in neonatal period.

Prospective study.

Term neonates without any major congenital malformation, delivered at B.R.D. Medical College, Gorakhpur and staying in the hospital for more than 24 hours where included in this study. The CANSCORE was evaluated on the basis of ceases of the CANSCORE Chart, score £ 24 was considered as evidence of fetal malnutrition. The score was correlated with I.U. Growth, and the influence of maternal factors on CANSCORE (malnutrition) and SGA was evaluated. The effect of Nutritional status as assessed by CANS and I.U. Growth curve on neonatal morbidity & mortality was studied. A comparison of the results in two-group i.e. malnutrition assessed by CANS and by I.U. growth was made.

A total of 750 newborns were evaluated during the study period (Jan 2002-jan2003). By CANSCORE 36.1% babies were malnourished while 25.18% were SGA by I.U. Growth. In malnourished group 20% AGA and 80% were SGA, while in well-nourished group 80% AGA and 20% were SGA, 44% babies of primiparous mother were malnourished by CANS. In anemic mothers group most of babies (68%) were malnourished by CANS, only 34% were malnourished delivered by non-anemic mothers, while the incidence of SGA was 51% in anemic mother group & 23.7% in non-anemic mothers. Mothers with Pregnancy induced hypertension (PIH) delivered 70% malnourished babies while in non PIH group mothers delivered only 34% malnourished babies by CANS. Neonatal morbidity like neonatal hyperbilirubinemia, sepsis, asphyxia, hypoglycemia and mortality were also more common in low CANS than in SGA babies.

AGA babies can also have evidence of Fetal malnutrition, all SGA were not malnourished by CANS. Mothers with anemia, PIH, Primiparity had higher chances of fetal malnutrition. Neonatal mortality and morbidity viz. hypoglycemia, septicemia, asphyxia, neonatal hypobilirubenemia were more common in low CANSCORE babies than in simple SGA babies. The percentage of babies showing malnutrition was more with CANS as compared to percentage of the SGA. The neonatal morbidity was more in babies showing fetal malnutrition whether AGA or SGA, not simply SGA without malnutrition by CANSCORE had higher morbidity than AGA well nourished babies.