Estimation of neonatal body fat percentage predicts neonatal hypothermia better than birthweight centile

Introduction PEA POD (TM) air displacement plethysmography quickly and noninvasively estimates neonatal body fat percentage (BF%). Low PEA POD (TM) 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 (TM) 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 (TM). Medical record review identified hypothermic (<36.5 degrees 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 (TM) BF% (AUC = 0.62) and birthweight centile (AUC = 0.61). Birthweight <10(th) centile demonstrated 11.9% sensitivity, 38.5% positive predictive value (PPV) and 92.5% specificity for hypothermia. At equal specificity, skinfold and PEA POD (TM) 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 (TM).

Automated summary

This study investigated whether skinfold measurements could effectively predict neonatal hypothermia and compared it with PEA POD (TM) measurements and birthweight centiles. The results showed that skinfold measurements and PEA POD (TM) measurements had similar predictive ability, with skinfold measurements being a better predictor of neonatal hypothermia.