{"title":"胎儿营养不良时 CAN 评分和比例指数的诊断效用以及中性粒细胞和血小板-淋巴细胞比率的变化","authors":"Olety Priyanka, S. Sindgikar","doi":"10.1177/09732179231215885","DOIUrl":null,"url":null,"abstract":"Nutritional status of neonates is best assessed using clinical assessment of nutrition (CAN) score and proportionality indices. The onset of malnutrition that begins in utero, termed fetal malnutrition (FM), can induce a state of inflammation. This study is aimed at estimating the prevalence of FM in different classes of births along with analysis of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in cord blood as markers of inflammation. It was a cross-sectional, descriptive study. The proportionality indices—body mass index (BMI), ponderal index (PI), and CAN score—were calculated. PI <2.2, BMI<11.2 kg/m2, and CAN score <25 were indicators of FM. The Chi-square test was used to test the sensitivity and specificity of CAN score against PI and BMI. A total of 100 term neonates were included, divided into 3 groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Fetal malnutrition was present in 16% of total neonates. The sensitivity and specificity of the CAN score was more than 85% with significant p-value {χ 2 = 33 (PI), χ 2 = 58.8 (BMI)}. Median NLR in FM was 1.63 ± 0.65, significantly ( P < .001) higher than well-nourished neonates. Platelet lymphocyte ratio did not have a significant difference. Clinical assessment of nutrition score showed a positive correlation with maternal ( r = 0.806, P < .001) and neonatal BMI ( r = 0.368, P < .001). Proportionality indices and CAN score can be interchangeably used to diagnose FM. The presence of higher NLR values in neonates with FM suggesting an underlying inflammatory process requires closer follow-up.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"67 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Utility of the CAN Score and Proportionality Indices and Variations in Neutrophil—and Platelet—Lymphocyte Ratios in Fetal Malnutrition\",\"authors\":\"Olety Priyanka, S. Sindgikar\",\"doi\":\"10.1177/09732179231215885\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Nutritional status of neonates is best assessed using clinical assessment of nutrition (CAN) score and proportionality indices. The onset of malnutrition that begins in utero, termed fetal malnutrition (FM), can induce a state of inflammation. This study is aimed at estimating the prevalence of FM in different classes of births along with analysis of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in cord blood as markers of inflammation. It was a cross-sectional, descriptive study. The proportionality indices—body mass index (BMI), ponderal index (PI), and CAN score—were calculated. PI <2.2, BMI<11.2 kg/m2, and CAN score <25 were indicators of FM. The Chi-square test was used to test the sensitivity and specificity of CAN score against PI and BMI. A total of 100 term neonates were included, divided into 3 groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Fetal malnutrition was present in 16% of total neonates. The sensitivity and specificity of the CAN score was more than 85% with significant p-value {χ 2 = 33 (PI), χ 2 = 58.8 (BMI)}. Median NLR in FM was 1.63 ± 0.65, significantly ( P < .001) higher than well-nourished neonates. Platelet lymphocyte ratio did not have a significant difference. Clinical assessment of nutrition score showed a positive correlation with maternal ( r = 0.806, P < .001) and neonatal BMI ( r = 0.368, P < .001). Proportionality indices and CAN score can be interchangeably used to diagnose FM. 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引用次数: 0
摘要
新生儿营养状况的最佳评估方法是使用营养临床评估(CAN)评分和比例指数。胎儿营养不良(FM)始于子宫内,可诱发炎症状态。本研究旨在估算不同类别新生儿的 FM 患病率,并分析作为炎症标志物的脐带血中中性粒细胞淋巴细胞比值(NLR)和血小板淋巴细胞比值(PLR)。这是一项横断面描述性研究。研究计算了比例指数--体重指数(BMI)、腹围指数(PI)和 CAN 评分。PI<2.2、BMI<11.2 kg/m2和CAN评分<25是FM的指标。采用卡方检验(Chi-square test)来检验 CAN 评分与 PI 和 BMI 的敏感性和特异性。共纳入 100 名足月新生儿,分为三组:小于胎龄组(SGA)、适于胎龄组(AGA)和大于胎龄组(LGA)。所有新生儿中有 16% 存在胎儿营养不良。CAN评分的灵敏度和特异性均超过85%,P值显著{χ 2 = 33(PI),χ 2 = 58.8(BMI)}。FM 新生儿的 NLR 中位数为 1.63 ± 0.65,明显高于营养良好的新生儿(P < .001)。血小板淋巴细胞比率没有明显差异。临床营养评估评分与产妇体重指数(r = 0.806,P < .001)和新生儿体重指数(r = 0.368,P < .001)呈正相关。比例指数和 CAN 评分可交替用于诊断 FM。如果患有 FM 的新生儿出现较高的 NLR 值,表明存在潜在的炎症过程,则需要进行更密切的随访。
Diagnostic Utility of the CAN Score and Proportionality Indices and Variations in Neutrophil—and Platelet—Lymphocyte Ratios in Fetal Malnutrition
Nutritional status of neonates is best assessed using clinical assessment of nutrition (CAN) score and proportionality indices. The onset of malnutrition that begins in utero, termed fetal malnutrition (FM), can induce a state of inflammation. This study is aimed at estimating the prevalence of FM in different classes of births along with analysis of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in cord blood as markers of inflammation. It was a cross-sectional, descriptive study. The proportionality indices—body mass index (BMI), ponderal index (PI), and CAN score—were calculated. PI <2.2, BMI<11.2 kg/m2, and CAN score <25 were indicators of FM. The Chi-square test was used to test the sensitivity and specificity of CAN score against PI and BMI. A total of 100 term neonates were included, divided into 3 groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Fetal malnutrition was present in 16% of total neonates. The sensitivity and specificity of the CAN score was more than 85% with significant p-value {χ 2 = 33 (PI), χ 2 = 58.8 (BMI)}. Median NLR in FM was 1.63 ± 0.65, significantly ( P < .001) higher than well-nourished neonates. Platelet lymphocyte ratio did not have a significant difference. Clinical assessment of nutrition score showed a positive correlation with maternal ( r = 0.806, P < .001) and neonatal BMI ( r = 0.368, P < .001). Proportionality indices and CAN score can be interchangeably used to diagnose FM. The presence of higher NLR values in neonates with FM suggesting an underlying inflammatory process requires closer follow-up.