Evaluation of internipple distance, sternum length and torso length as a screening test in newborn infants' growth in Salahaddin General Hospital

Abstract

Background: knowledge of the normal growth and development of children is essential for preventing and detecting disease by recognizing overt deviation from normal pattern. Various genetic syndromes, birth defect and acquired diseases are characteristic by abnormal shape and size of the chest and site of nipple. These abnormalities may be evident in longitudinal measurements as short chest, or in horizontal measurement as deviations in chest circumference.Aim of the study: to test and make internipple distance, sternum length, torso length as a part of growth measures in evaluation and diagnosis of growth assessment in newborn infants.

Patients & methods: A cross sectional study involve 732 newborns consist of 708 normal newborns: 570term (298 male and 272 female), 112 preterm (male 42 and female 70) and 26 post-term (male 19 and 7 female); while congenital anomalies were observed in 24 newborns: 2lterm newborn (male 6 and female 15) and 3preterm male between gestational ages 27 and 43 weeks and weighed from 700 gram — 5 kg delivered or attended to Salahaddin general hospital during period from 15thMay 2017 to 15th September 2017. Weight, length, occipitofrontal circumference , chest circumference , torso length, internipple distance and sternum length were measured for each newborns.

Results: There was a difference found between male and female. The mean internipple distance for term newborns (8.7 cm) in male and( 8.6 cm) in female while in per-term (6.16 cm) and for post-term (9.4 cm) . The mean internipple index in our study was being 26% as a larger chest circumference decreases the internipple index. The mean of sternum length in term male (7.8 cm) and in term female (8.7 cm) while in pre-term (6.1cm) and in post-term (8.9 cm) the sternum length in male is shorter than in female . The sternal index is about ( 0.47) in our study. The mean of torso length in term male (20 cm) and in term female (19.8 cm) while in pre-term (17 cm) and in post-term (22.8 cm). The internipple distance in screening test was sensitive and specific for males (81.2% and 84.3%) and only specific for female 90 % , while sternum length is sensitive and specific for females (89 % and 94.4 %) and males(70% and 91.8% ) as well as torso length which is specific and sensitive in both sex.

Conclusions: internipple distance, sternum length and torso length varies with , gestational age and increase as the pregnancy continue. A internipple distance of 9.6 cm or an internipple index of 28.2% in the neonatal period indicates widely spaced nipples. and the sternum is considered short when sternal-torso index is below (0.33)