Fetal malnutrition among neonates in African countries: a CAN score systematic review and meta-analysis.
Africa
Fetal malnutrition
Neonates
Newborns
Journal
Nutrition journal
ISSN: 1475-2891
Titre abrégé: Nutr J
Pays: England
ID NLM: 101152213
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
20
07
2023
accepted:
22
07
2024
medline:
7
9
2024
pubmed:
7
9
2024
entrez:
6
9
2024
Statut:
epublish
Résumé
To reduce neonatal mortality, it is necessary to identify neonates with fetal malnutrition at birth using the clinical assessment score (CAN score). Furthermore, comprehensive summary data that shows burden of fetal malnutrition in Africa is scarce. As a result, this systematic review and meta-analysis aimed to assess fetal malnutrition among newborns in Africa. The PRISMA guidelines were used for this study. Articles were obtained from databases and websites. The outcome of the study was fetal malnutrition, as determined using the CAN score. The meta-analysis of the primary and secondary outcomes was performed using Stata version 18 statistical software. The pooled prevalence with a 95% CI was estimated using the random effect method with the Der Simonian Liard model. This meta-analysis and systematic review included 5356 newborns from 13 studies. The pooled prevalence of fetal malnutrition (FM) among newborns diagnosed using the CAN score in Africa was 19% [95% CI: 17, 22]. Based on subgroup analysis by publication year, the lowest prevalence of fetal malnutrition 17% (95% CI: 9-27) was observed in the studies published in the years 2020-2023. Maternal and fetal factors were significantly associated with fetal malnutrition. Nearly one-fifth of neonates delivered in Africa were found to have fetal malnutrition based on the clinical evaluation of nutritional status. It has also been established that maternal malnutrition, a lack of proper treatment during pregnancy, maternal malnutrition, and newborn morbidities were associated with fetal malnutrition. To prevent fetal malnutrition, integrated efforts should be made for early maternal infection screening. Furthermore, maternal nutritional therapy should be explored for malnourished pregnant women.
Sections du résumé
BACKGROUND
BACKGROUND
To reduce neonatal mortality, it is necessary to identify neonates with fetal malnutrition at birth using the clinical assessment score (CAN score). Furthermore, comprehensive summary data that shows burden of fetal malnutrition in Africa is scarce. As a result, this systematic review and meta-analysis aimed to assess fetal malnutrition among newborns in Africa.
METHOD
METHODS
The PRISMA guidelines were used for this study. Articles were obtained from databases and websites. The outcome of the study was fetal malnutrition, as determined using the CAN score. The meta-analysis of the primary and secondary outcomes was performed using Stata version 18 statistical software. The pooled prevalence with a 95% CI was estimated using the random effect method with the Der Simonian Liard model.
RESULTS
RESULTS
This meta-analysis and systematic review included 5356 newborns from 13 studies. The pooled prevalence of fetal malnutrition (FM) among newborns diagnosed using the CAN score in Africa was 19% [95% CI: 17, 22]. Based on subgroup analysis by publication year, the lowest prevalence of fetal malnutrition 17% (95% CI: 9-27) was observed in the studies published in the years 2020-2023. Maternal and fetal factors were significantly associated with fetal malnutrition.
CONCLUSION
CONCLUSIONS
Nearly one-fifth of neonates delivered in Africa were found to have fetal malnutrition based on the clinical evaluation of nutritional status. It has also been established that maternal malnutrition, a lack of proper treatment during pregnancy, maternal malnutrition, and newborn morbidities were associated with fetal malnutrition. To prevent fetal malnutrition, integrated efforts should be made for early maternal infection screening. Furthermore, maternal nutritional therapy should be explored for malnourished pregnant women.
Identifiants
pubmed: 39243026
doi: 10.1186/s12937-024-00989-3
pii: 10.1186/s12937-024-00989-3
doi:
Types de publication
Systematic Review
Journal Article
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
102Informations de copyright
© 2024. The Author(s).
Références
Metcoff J. Clinical assessment of nutritional status at birth: fetal malnutrition and SGA are not synonymous. Pediatr Clin North Am. 1994;41(5):875–91.
doi: 10.1016/S0031-3955(16)38836-8
pubmed: 7936778
Korkmaz A, et al. Fetal malnutrition and its impacts on neonatal outcome in preterm infants. Turk J Pediatr. 2011;53(3):261–8.
pubmed: 21980806
Kim S, Fleisher B, Sun JY. The long-term health effects of fetal malnutrition: evidence from the 1959–1961 China great leap forward famine. Health Econ. 2017;26(10):1264–77.
doi: 10.1002/hec.3397
pubmed: 27539791
Fall CH. Fetal malnutrition and long-term outcomes, in Maternal and Child Nutrition: The First 1,000 Days. 2013, Karger Publishers. pp. 11–25.
Adebami OJ, Oyedeji GA, Owa JA, Oyelami OA. Maternal factors in the etiology of fetal malnutrition in Nigeria. Pediatr Int. 2007;49(2):150–5. https://doi.org/10.1111/j.1442-200X.2007.02328.x .
Crosby WM. Studies in fetal malnutrition. Am J Dis Child. 1991;145(8):871–6.
pubmed: 1858723
Ezenwa BN, et al. Comparative study of Clinical Assessment of Nutritional status score and proportionality indices in the assessment of fetal malnutrition in term newborns. Nigerian Med Journal: J Nigeria Med Association. 2016;57(2):124.
doi: 10.4103/0300-1652.182075
Rushdi R, et al. Fetal malnutrition: a Multicenter cross-sectional study in Egypt. Am J Perinatol. 2018;35:01.
Janardhan AM, Alok S, Janardhan L. Detection of fetal malnutrition and its associated maternal factors in a rural setting 2020.
Dastgerdi RC et al. Assessment of fetal malnutrition based on the CANSCORE Index and Anthropometric Indices. J Nutr Fasting Health, 2022. 10(1).
Bolaji O, et al. Maternal serum zinc levels and fetal malnutrition of term babies in Nigeria. Pakistan J Nutr. 2016;15(7):673–9.
doi: 10.3923/pjn.2016.673.679
García-Contreras C, et al. Fetal growth-retardation and brain-sparing by malnutrition are associated to changes in neurotransmitters profile. Int J Dev Neurosci. 2017;57:72–6.
doi: 10.1016/j.ijdevneu.2017.01.005
pubmed: 28104460
Moher D, et al. The PRISMA Group. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. PLoS Med. 2009;6(6):e1000097.
doi: 10.1371/journal.pmed.1000097
pubmed: 19621072
pmcid: 2707599
Luchini C, et al. Assessing the quality of studies in meta-analyses: advantages and limitations of the Newcastle Ottawa Scale. World J Meta-Analysis. 2017;5(4):80–4.
doi: 10.13105/wjma.v5.i4.80
Morgan ROBINS-E, Rooney R, Taylor A, Thayer K, Silva K, Lemeris R, Akl C, Arroyave A, Bateson W, Berkman T, Demers N, Forastiere P, Glenn F, Hróbjartsson B, Kirrane A, LaKind E, Luben J, Lunn T, McAleenan R, McGuinness A, Meerpohl L, Mehta J, Nachman S, Obbagy R, Connor J, Radke A, Savović E, Schubauer-Berigan J, Schwingl M, Schunemann P, Shea H, Steenland B, Stewart K, Straif T, Tilling K, Verbeek K, Vermeulen V, Viswanathan R, Zahm M. S, Sterne J). Risk Of Bias In Non-randomized Studies - of Exposure (ROBINS-E). Launch version, 20 June 2023. 2023.
Higgins JPT, et al. Measuring Inconsistency meta-analyses. 2003;327(7414):557–60.
Lin L, Chu H. Quantifying publication Bias in Meta-Analysis. Biometrics. 2017;74(3):785–94.
doi: 10.1111/biom.12817
pubmed: 29141096
pmcid: 5953768
Adebami OJ, et al. Prevalence and problems of foetal malnutrition in term babies at Wesley Guild Hospital, South Western Nigeria. West Afr J Med. 2007;26(4):278–82.
pubmed: 18705426
Sume BW. Fetal malnutrition and associated factors among newborn babies delivered at Debre Markos Comprehensive Specialized Hospital, Ethiopia. Int J Afr Nurs Sci. 2023;18:100543.
Adebami OJ, Owa J. Comparison between CANSCORE and other anthropometric indicators in fetal malnutrition. Indian J Pediatr. 2008;75:439–42.
doi: 10.1007/s12098-008-0069-7
pubmed: 18537004
Yahaya-Kongoila S. Prevalence and risk factors for fetal malnutrition in newborns in University of Ilorin Teaching Hospital, Ilorin. Faculty of PAEDIATRICS; 2015.
Tongo OO, et al. Static skinfold thickness in African newborns as an index of fetal nutritional assessment. Paediatr Int Child Health. 2013;33(3):161–4.
doi: 10.1179/2046905513Y.0000000061
pubmed: 23930728
Josiah AE, Opara PI, Nte AR. Prevalence of and risk factors for fetal malnutrition in term babies delivered at a Tertiary Hospital in Southern Nigeria. J Clin Neonatology, 2018. 7(1).
EZENWA BN. Determination of fetal malnutrition in term and preterm neonates at the Lagos University Teaching Hospital using CANSCORE and anthropometry. Faculty of PAEDIATRICS; 2012.
Ezenwa B, et al. Comparative study of Clinical Assessment of Nutritional status score and proportionality indices in the assessment of fetal malnutrition in term newborns. Nigerian Med J. 2016;57(2):124–8.
doi: 10.4103/0300-1652.182075
BOLAJI OB. FETAL MALNUTRITION AND MATERNAL SERUM LEVELS OF ZINC AT IDO-EKITI, SOUTHWESTERN NIGERIA. Faculty of PAEDIATRICS; 2015.
Adebami OJ, et al. Associations between placental and cord blood malaria infection and fetal malnutrition in an area of malaria holoendemicity. Am J Trop Med Hyg. 2007;77(2):209–13.
doi: 10.4269/ajtmh.2007.77.209
pubmed: 17690388
Tesfa D, Teshome F, Ambaw B. Fetal Malnutrition and Associated Factors among Term Newborn Babies at Birth in South Gondar Zone Hospitals, Northwest Ethiopia International Journal of Pediatrics, 2021. 2021.
Deodhar J, Jarad R. Study of the prevalence of and high risk factors for fetal malnutrition in term newborns. Ann Trop Paediatr. 1999;19(3):273–7.
doi: 10.1080/02724939992365
pubmed: 10715714
Natarajan V, et al. Maternal and placental risk factors for small gestational age and fetal malnutrition. Curr Pediatr Reviews. 2023;19(2):187–96.
doi: 10.2174/1573396318666220705154424
Sebastiani G, et al. Eating disorders during Gestation: implications for Mother’s Health, fetal outcomes, and epigenetic changes. Front Pediatr. 2020;8:587.
doi: 10.3389/fped.2020.00587
pubmed: 33042925
pmcid: 7527592
Kerr K, et al. Differences in Nutrition interventions among malnourished hospitalized patients. Curr Developments Nutr. 2020;4(Supplement2):1129–1129.
Marquis GS, Martin SL, Lartey A. The multiple dimensions of participation: key determinants of Nutrition intervention outcomes. Curr Developments Nutr. 2023;7(5):100001.
doi: 10.1016/j.cdnut.2022.100001
Singh S et al. Maternal health: a reflector for fetal malnutrition. Indian J Child Health, 2019: p. 353–6.
Chinnakali P, et al. Prevalence of household-level food insecurity and its determinants in an urban resettlement colony in north India. J Health Popul Nutr. 2014;32(2):227.
pubmed: 25076660
pmcid: 4216959
Gustafsson J. Neonatal energy substrate production. Indian J Med Res. 2009;130(5):618–23.
pubmed: 20090117
Han T, et al. Fetal malnutrition is associated with impairment of endogenous melatonin synthesis in pineal via hypermethylation of promoters of protein kinase C alpha and cAMP response element-binding. J Pineal Res. 2021;71(4):e12764.
doi: 10.1111/jpi.12764
pubmed: 34486775
Central statistical agency, E. and, Calverton M. USA, Ethiopia demographic and health survey, Addis Ababa, Ethiopia 2016.
Opara P, Josiah A, Nte A. Morbidity and weight gain patterns amongst babies with fetal malnutrition in Port Harcourt, Nigeria. J Pediatr Neonatal Individualized Med (JPNIM). 2019;8(2):e080208–080208.
Raven JH, et al. What is quality in maternal and neonatal health care? Midwifery. 2012;28(5):e676–83.
doi: 10.1016/j.midw.2011.09.003
pubmed: 22018395
ten Hoope-Bender P, et al. Improvement of maternal and newborn health through midwifery. Lancet. 2014;384(9949):1226–35.
doi: 10.1016/S0140-6736(14)60930-2
pubmed: 24965818
Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, central Ethiopia. BMC Health Serv Res. 2013;13(1):1–10.
doi: 10.1186/1472-6963-13-256