Fetal malnutrition often goes undiagnosed. It is important to do a complete physical exam, especially when there are maternal risk factors.
The duration (throughout the pregnancy vs only third trimester) and severity (mild to severe) of the malnutrition will determine how the infant is affected.
A neonate who is small for gestational age (SGA) may or may not have fetal malnutrition.
A neonate with fetal malnutrition may have body length, head circumference and other anthropometric measurements within the "normal" range. The body weight and ponderal index often are low compared to neonates without malnutrition.
The diagnosis of fetal malnutrition is based on:
(1) reduction in subcutaneous fat and muscle
(2) looseness of skin
The CANS score (CANSCORE) is one method of quantifying these findings.
The amount of adipose tissue and muscle can be seen on MRI. A careful review of the MRI can support the diagnosis or help to identify a neonate who should be carefully examined.
It would be interesting if prealbumin is lower with fetal malnutrition.
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