Nutritional Status Assessment of Newborns: Comparison of the CAN Score (Metcoff Methodology), Growth Curves, Anthropometry, and Plicometry.

Abstract

Fetal malnutrition, characterized by inadequate fat and muscle accretion during intrauterine development, has been linked to adverse outcomes, ranging from neonatal complications to long-term developmental and metabolic disorders. Traditionally, growth curves and birth weight have guided the assessment of newborns' nutritional status; however, these measures often do not accurately reflect changes in body composition. This review compares several evaluation methods-CAN score (Metcoff methodology), body mass index (BMI), Ponderal Index (PI), McLaren Index, mid-upper arm circumference (MUAC), and plicometry-to provide suggestions on selecting the most appropriate approach, depending on the healthcare setting and population needs. Findings from multiple international studies indicate that the CAN score and BMI are among the most accurate tools, offering better sensitivity and specificity than traditional anthropometric indicators. The CAN score, based on a clinical observation of fat deposits, skin texture, and muscle tone, has been widely used in Latin America and remains a practical and cost-effective option. Nonetheless, recent research suggests that BMI, mainly when used alongside the PI, may outperform the CAN score in certain contexts. Considering the complexity of fetal nutritional assessments, integrating multiple methods enhances the diagnostic accuracy. Early identification of malnourished newborns is essential for timely intervention and improved long-term outcomes. Standardizing these diagnostic tools globally could advance efforts to reduce neonatal morbidity and mortality by 2030.