Correlation of foot length and gestational maturity in neonates

Sunil Gavhane, Anjali Kale, Akshay Golawankar, Avinash Sangle


Background: Accurate assessment of gestation maturity is not possible in all newborn infants specially when they are sick and need intensive care support. The aim was to study correlation of foot length (FL) with gestational age and other anthropometric measures at birth among preterm, term and post-term neonates.

Methods: Prospective observational study was done. 800 babies born at MGM Medical College Aurangabad from December 2012 to November 2014 were enrolled. FL at birth was measured from the center of the back of the heel to the tip of the big toe. Gestational assessment was done using modified Ballard’s scoring on day one. Based on gestational age, babies were grouped as preterm, term and post term babies. All the three groups of babies were categorised into small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) groups using lubchenco intrauterine growth curves. Linear regression analysis was done to investigate the relation of FL to gestational age, birth weight (BW), head circumference (HC) and crown heel length (CHL).

Results:There were 52.5% males and 47.5% females. Of the 800 newborns, preterm babies were 124 (15.5%), term babies were 604 (75.5%) and post-term babies were 72 (9%). The mean foot length was 7.42 cm with a range of        4.5-8.8 cm. Foot length correlated significantly (p <0.05) with gestational age, birth weight, head circumference and crown heel length in preterm small for gestational age (SGA), preterm appropriate for gestational age (AGA), term Small for gestational age (SGA) and term appropriate for gestational age (AGA) groups. The correlation coefficient of foot length with gestational age was maximum in preterm AGA (r=0.81) and preterm SGA groups (r=0.75) followed by term SGA (r=0.48) and term AGA (r=0.44). Other groups had no correlation between foot length and gestational age. Post-term AGA and post-term SGA groups had correlation between foot length and birth weight.

Conclusions:Foot length correlated significantly with gestational age and other anthropometric parameters in preterm and term infants.    



Preterm babies, Foot length, Small for gestational age, Birth weight

Full Text:



Lucas A. Enteral nutrition. In: Tsang R, Lucas A, Uaay R, Zlotkin S, eds. Nutritional Needs of the Preterm Infant: Scientific Basis and Practical Guidelines. Baltimore:Williams and Wilkins. 1993:209-24.

Cooke RW, Lucas A, Yudkin PL, Pryse DJ. Head circumference as an index of brain weight in the fetus and newborn. Early Hum Dev. 1977;1:145-9.

Sparks JW, Ross JC, Cetin I. Intrauterine growth and nutrition. In: Polin RA, Fox WW, eds. Fetal and Neonatal Physiology. Philadelphia: WB Saunders;1992:267-90.

James DK, Dryburgh EH, Chiswick ML. Foot length a new and potentially useful measurement in the neonate. Arch Dis Child. 1979;54(3):226-30.

Gohil JR, Sosi M, Vani SN, Desai AB. Foot length measurement in the neonate. Indian J Pediatr. 1991;58:675-7.

Ballard JL, Novak KK, Driver M. A simplified score for assessment of fetal maturation of newly born infants. J Pediatr. 1979;95(5):769-74.

Lubchenco L, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated from live born birth weight data at 24 to 42 weeks of gestation. Pediatrics. 1963;32:793-800.

Anderson M, Blais M, Green WT. Growth of the normal foot during childhood and adolescence:length of the foot and interrelations of foot, stature, and lower extremity as seen in serial records of children between 1-18 years of age. Am J Phys Anthropol. 1956;14:287-308.

Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D’Alton ME. Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol. 1987;156:350-5.

Markowski B, Lawler SD. Use of early fetal tissues obtained from suction termination of pregnancy. Lancet. 1977;1:186-8.

Pospisilova ZV. Determination of the body length of the fetus with the aid of the length of the sole of the foot. Biologia. 1962;17:49-52.

Embleton ND, Deshpande SA, Scott D, Wright C, Milligan DW. Foot length, an accurate predictor of nasotracheal tube length in neonates. Arch Dis Child Fetal Neonatal Ed. 2001;85:60-4.