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Erschienen in:
04.08.2018 | Correspondence
Anterior Fontanelle Size in Healthy Indian Late Preterm and Full Term Newborns: Correspondence
Erschienen in: Indian Journal of Pediatrics | Ausgabe 2/2019
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To the Editor: We read the article by Roy et al. published in IJP and would like to applaud the authors for generating normative data for an underexplored but important anthropometric parameter [1]. However, there are certain points we would like to highlight, clarification of which will bring more clarity to this issue.
1.
Authors used Fenton 2003 growth charts for classifying babies as Small for gestational age (SGA), Appropriate for gestational age (AGA) and Large for gestational age (LGA). However for calculation of Z scores for SGA babies’, authors used “Research bulk calculator spreadsheet” which is based on Fenton 2013 growth charts. The Fenton 2013 charts [2] are based upon much larger sample and the centiles cutoff’s are different from Fenton 2003 charts [3]. The best practice would have been using Fenton 2013 chart for all anthropometric parameters, as they are based on very large population and are universally acceptable.
2.
The authors stated that the SGA neonates have larger anterior fontanelle (AF) size compared to others. However, in results (Table 1) the mean AF size was larger in AGA neonates (2.32 ± 0.54) followed by SGA (2.27 ± 0.55) and LGA (2.11 ± 0.47).
3.
The authors stated that there was a strong correlation between birth weight and AF size with r = 1.012. However, the maximum value of Pearson correlation coefficient can be 1.00 (perfect correlation).
4.
Severe moulding of skull during vaginal delivery can affect the measurement of occipitofrontal circumference and AF size and may persist for even few weeks [4]. In present study AF was measured at 48 h. Did authors exclude the cases with severe moulding? We understand that it’s impractical to withhold discharge of these babies for study purposes, but these babies must be excluded to avoid the measurement error.
5.
The authors stated that one study [4] showed a positive correlation between AF size and birth weight but was short of being statistically significant (p = 0.06). But, if we look from statistical point of view then there was no correlation.