Measuring newborn foot length to estimate gestational age in a high risk Northwest Ethiopian population

Introduction: Preterm birth is defined as all births before 37 completed weeks of gestation. Globally, the prevalence rate of preterm birth ranges from 47.5 to 137 per 1000 live births. In Ethiopia, the prevalence of preterm birth is 10.1%. Several anthropometric parameters, particularly, head circumference and foot length(FL) have been used as a proxy measure for gestational age(GA).

Objective: To assess the use of newborn foot length as a screening tool to identify preterm newborns and correlation factors at the University of Gondar Comprehensive Specialized Hospital (UOG CSH), Northwest Ethiopia.

Methods: Institutional based cross-sectional study design was conducted on 205 newborns admitted to a neonatal intensive care unit, UOG CSH. Systematic sampling technique was employed. Optimal cutoff newborn foot length and area under the curve (AUC) was calculated by the receiver operating characteristic curve analysis to assess the power of foot length measurement to diagnosis prematurity.

Results: The mean foot length was 7.41±0.67 cm with a range of 5.4-8.6 cm. Gestational age had a significant strong positive correlation with foot length(r = 0.865). The regression equation derived was GA = 4.5*FL + 3.61. Foot length had strong power (AUC = 0.99) to differentiate preterm from term newborns. A threshold newborn foot length of ≤7.35 cm had a sensitivity and specificity of 98.5% and 96.3%, respectively to predict prematurity.

Conclusion: Foot length had a high sensitivity and specificity in identifying preterm newborns, making it a reliable tool to identify preterm birth in a rural setting.

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