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Description

The Clinical Assessment of Nutritional Status Score can be used to evaluate a neonate for evidence of fetal malnutrition.


 

Sites clinically evaluated:

(1) hair

(2) cheeks

(3) neck and chin

(4) arms

(5) legs

(6) back

(7) buttocks

(8) chest

(9) abdomen

 

Each area is graded from 4 (normal) to 1 (malnutrition).

 

Site

Grade 4

Grade 1

hair

thick, smooth, silky, easily groomed

straing, hair with depigmented stripe (flag sign)

cheeks

full buccal pads and round face

minimal buccal fat with narrow, flat face

neck and chin

double or triple chin fat fold, neck not evident

thin chin, no fat fold, neck very evident with loose and wrinkled skin

arms

full, round, no loose skin

"accordion" folding, loose skin, easily grasped and pulled away

legs

full, round, no loose skin

"accordion" folding, loose skin, easily grasped and pulled away

back

difficult to grasp and lift skin in the interscapular area

loose skin that is easily lifted

buttocks

full, round gluteal fat pads

minimal gluteal fat, loose and deeply wrinkled skin

chest

full, round, with no visible ribs

prominent ribs, loss of intercostals tissue

abdomen

full, round, without loose skin

distended or scaphoid, very loose skin, wrinkled skin, "accordion" folds

 

total score =

= SUM(points for all 9 areas)

 

Interpretation:

• minimum score: 9 (significant fetal malnutrition)

• maximum score: 36 (normal)

• When comparing values, the presence of scores at both extremes (1 or 4) should prompt reassessment.

 


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