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Public Health Nutr. 2019 Jan;22(1):147-156. doi: 10.1017/S1368980018002549. Epub 2018 Oct 18.

Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA: simple tools for a critical measure.

Author information

1
1Kaiser Permanente Northern California Division of Research,2000Broadway,Oakland,CA94612,USA.
2
3Department of Nutritional Sciences,University of Texas at Austin,Austin,TX,USA.
3
4Division of Epidemiology and Community Health,School of Public Health,University of Minnesota,Minneapolis,MN,USA.
4
5Center for Human Nutrition,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
5
6Department of Epidemiology and Biostatistics,Michigan State University,East Lansing,MI,USA.
6
7David Geffen School of Medicine,University of California,Los Angeles,CA,USA.
7
8Department of Pediatrics, University of California,Irvine,CA,USA.
8
2Eunice Kennedy Shriver National Institute of Child Health and Human Development,Bethesda,MD,USA.

Abstract

OBJECTIVE:

In resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).

DESIGN:

Cross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).

SETTING:

National Children's Study-Formative Research in Anthropometry (2011-2012).

SUBJECTS:

Multi-racial/ethnic infants and children aged <6 years (n 1473).

RESULTS:

Developed Models 1-4 had high predictive precision (R 2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas (-1·7, 9·2 and -4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.

CONCLUSIONS:

Ulna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.

KEYWORDS:

Anthropometric measure; Estimation; Forearm; Paediatric weight; Ulna

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