Estimation of neonatal body fat percentage predicts neonatal hypothermia better than birthweight centile
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2022-01-01
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Journal of Maternal-Fetal and Neonatal Medicine
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TAYLOR & FRANCIS LTD
Melbourne Authors
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Minerva Elements
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Journal Article
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Banting, S. A., Dane, K. M., Charlton, J. K., Tong, S., Hui, L., Middleton, A. L., Gibson, L. K., Walker, S. P. & MacDonald, T. M. (2022). Estimation of neonatal body fat percentage predicts neonatal hypothermia better than birthweight centile. Journal of Maternal Fetal and Neonatal Medicine, 35 (25), pp.9342-9349. https://doi.org/10.1080/14767058.2022.2032634.
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INTRODUCTION: PEA POD™ air displacement plethysmography quickly and noninvasively estimates neonatal body fat percentage (BF%). Low PEA POD™ BF% predicts morbidity better than classification as small-for-gestational-age (SGA; <10th centile), but PEA PODs are not widely available. We examined whether skinfold measurements could effectively identify neonates at risk; comparing skinfold BF%, PEA POD™ BF% and birthweight centiles' prediction of hypothermia - a marker of reduced in utero nutrition. METHODS: Neonates had customized birthweight centiles calculated, and BF% prospectively estimated by: (i) triceps and subscapular skinfolds using sex-specific equations; and (ii) PEA POD™. Medical record review identified hypothermic (<36.5 °C) episodes. RESULTS: 42/149 (28%) neonates had hypothermia. Skinfold BF%, with an area under the curve (AUC) of 0.66, predicted hypothermia as well as PEA POD™ BF% (AUC = 0.62) and birthweight centile (AUC = 0.61). Birthweight <10th centile demonstrated 11.9% sensitivity, 38.5% positive predictive value (PPV) and 92.5% specificity for hypothermia. At equal specificity, skinfold and PEA POD™ BF% more than doubled sensitivity (26.2%) and PPV increased to 57.9%. CONCLUSION: Neonatal BF% performs better to predict neonatal hypothermia than birthweight centile, and may be a better measure of true fetal growth restriction. Estimation of neonatal BF% by skinfold measurements is an inexpensive alternative to PEA POD™.