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Air displacement plethysmography is a non-invasive technique that uses total body volume and mass to derive a two-compartment model of body composition that includes percentage body fat (%BF) and lean body mass (%LBM). Fortunately, more sophisticated infant body composition methods are now feasible without a need for water submersion. 15, 16 Hydrostatic weighing is not suitable for newborn body composition studies because complete water submersion is necessary to calculate total body volume. Furthermore, this technique is more likely to permit clear visualization of soft tissue borders and more confident tracing around each volume slice because only the mid-limb is analyzed.Īfter birth, neonatal infant body composition is traditionally evaluated using birth weight and anthropometric measurements, including the ponderal index and skin-fold thickness. 14 These measurements are reproducible and rapidly obtained because only five transverse slices need to be traced around the mid-limb. 2– 13 We previously reported that fractional limb volume can be used for fetal growth assessment and weight estimation using three-dimensional ultrasonography (3DUS).
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Several related parameters, such as mid-arm fat and lean mass, mid-thigh fat and lean mass, abdominal fat mass, subscapular fat mass, cheek-to-cheek diameter and buttocks have been used to assess fetal body composition. Soft tissue assessment may provide additional information about generalized fetal nutritional status. Unfortunately, this approach does not distinguish between fetuses that are small or large, but otherwise normal, from others that are truly malnourished.
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Fetal size is usually categorized on the basis of estimated fetal weight (EFW) being small (90 th percentile, LGA) for gestational age. Over four decades ago, Battaglia and Lubchenco 1 developed a landmark classification for neonatal growth outcome and this statistical approach has been applied to fetal weight assessment as well. Most obstetricians rely on uterine fundal height, fetal abdominal circumference (AC) measurement and/or a sonographic estimate of fetal weight for the detection of intrauterine growth restriction (IUGR). A final classification of neonatal growth outcome depends on how this development is defined. Fetal growth is a result of complex interactions between several maternal, fetal and placental mechanisms.