A comparative study of head circumference and foot length as a measure of low birth weight in neonates


  • Vaibhav B. Rathod Department of Pediatrics, SMBT Institute of Medical Sciences and Research Centre, Dhamangaon, Nashik, Maharashtra, India
  • Nitin S. Mehkarkar Department of Pediatrics, SMBT Institute of Medical Sciences and Research Centre, Dhamangaon, Nashik, Maharashtra, India
  • Vaibhav K. Gode Department of Pediatrics, SMBT Institute of Medical Sciences and Research Centre, Dhamangaon, Nashik, Maharashtra, India




New-born, LBW, Anthropometry, Head circumference, Foot length


Background: Birth weight is the single most important indicator of survival, growth and overall development of the child.  New-borns with less than 2.5 kg birth weight are termed as low birth weight (LBW). Approximately 28% babies in India are LBW. LBW is associated with high neonatal morbidity and mortality. Early diagnosis of LBW and apt intervention can lead to favourable outcome. The 70-80% of births take place either at home or at peripheral hospitals. Measuring birth weight is difficult in India due to resource limited set up. There is a need of alternative methods to detect LBW which should be simple, handy, quick and cost effective. Hence, we decided to do study of correlation of calf muscle circumference and chest circumference with birth weight to determine LBW in new-borns.  Aim of the study was to study head circumference and foot length in diagnosing LBW babies. Objectives were to correlate above-said anthropometric parameters with birth weight and to decide indicator with better correlation with birth weight amongst head circumference and foot length

Method: Its a cross sectional study conducted in tertiary care centre in North Maharashtra. The 162 new-borns (34- 42 weeks gestation) were included in Study. Birth weight, head circumference, and foot length were measured with appropriate scientific method. Results are analyzed with SPSS software and Microsoft excel.

Results: Cut-off value to detect LBW is 31cm and 8.2 cm for head circumference and foot length respectively. Head circumference had better correlation (r=0.73) as compared to foot length (r=0.30). Head circumference has 87% sensitivity and 68% specificity as compare to foot length which has 74.8% sensitivity and 46.8% specificity respectively.

Conclusions: Head circumference and foot length circumference can be used to determine LBW, though larger study with a greater number of patients is needed to establish precise correlation.


World Health Organization; UNICEF. Low Birth Weight: A Tabulation of Available Information. Geneva, Switzerland/New York, NY: World Health Organization/ UNICEF. 1992. Available at: https://www.who.int/india/health-topics/newborn-health. Accessed on 3 June 2022.

Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L, Lancet Neonatal Survival Steering Team: Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005;365:977-88.

Mullany LC, Darmstadt GL, Coffey P, Khatry SK, LeClerq SC, Tielsch JM. A low cost, colour coded, hand held spring scale accurately categorises birth weight in low resource settings. Arch Dis Child. 2006;91(5):410-13.

Risnes KR, Vatten LJ, Baker JL, Jameson K, Sovio U, Kajantie E et al. Birthweight and mortality in adulthood: a systematic review and meta-analysis. Int J Epidemiol. 2011;40:647-61.

Kewal K. Anthropometry in Forensic Medicine and Forensic Science-'Forensic Anthropometry'. Internet J Forensic Sci. 2007;2:10.5580/1dce.

Shastry CKR, Bhat BPR. Anthropometric measurements newborns. Int J Contemp Pediatric. 2015;2(2):85-9.

Raymond EG, Tafari N, Troendle JF, Clemens JD. Development of a practical screening tool to identify preterm, low-birth weight neonates in Ethiopia. Lancet. 1994;344:524-7.

Jelliffe DB. The assessment of the nutritional status of the community (with special reference to field surveys in developing regions of the world). Geneva: World Health Organization, 1966: 64-76. Available at: https://apps.who.int/iris/handle/10665/41780. Accessed on 3 June 2022.

Kulkarni MK, Rajendran NK. Values for foot length in new-borns. Indian Paediatr. 1992;29(4):507-9.

Gowri S, Kumar GV. Clinical study of the correlation of foot length and birth weight among new-borns in a tertiary care hospital. Int J Contemp Paediatric. 2017;4:979-83.

Srinivasa S, Manasa G, Madhu GN. Foot length of new-born: Its correlation with gestational age and various anthropometric parameters. Curr Pediatrics Res. 2017;21(2):248-53.

Mukherjee S, Roy P, Mitra S, Chaterjee SM. Measuring new born foot length to identify small babies in need of extra care: A cross sectional hospital-based study. Iran J Pediatrics. 2013;23(5):50812.

Amar MT, Rewat M, Amol L. Neonatal foot length: An alternative predictor of low-birth-weight babies in rural India. Acad J Ped Neonatal. 2016;1:555-69.

Ashish KC, Viktoria N, Ravi V, Surabhi A, Mats M. Validation of the foot length measure as an alternative tool to identify low birth weight and preterm babies in a low-resource setting like Nepal: A cross-sectional study. BMC Pediatr. 2015;15:43.

Mullany LC, Darmstadt GL, Khatry SK, LeClerq SC, Tielsch JM. Relationship between the surrogate anthropometric measures, foot length and chest circumference and birth weight among new-borns of Sarlahi, Nepal. European J Clini Nutri. 2007;61:40-6.

Saroj AK, Sharma JN, Singh M. Measurement of neonatal foot length to identify low birth weight babies: A cross-sectional hospital-based study. J Dental Med Sci. 2016;15(6):49-55.

Sudhapriya P, Dwivedi R, Anushadipti, Sarma KVS. Anthropometric measurements– A study on options for identification of small babies in need of extra care. Int J Pediatrics Res. 2019;6(01):35-41.

Akukwu DA, Uloneme GC, Akukwu BC, Alagwu EA. Detection of low-birth-weight new-borns by foot length as proxy-measure for birth weight. UKJPB. 2017;5(3):35-40.

Elizabeth N, Christopher O. Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: A hospital based cross sectional study. BMC Pediatr. 2013;13:54.

Taksande A, Vilhekar KY, Chaturvedi P, Gupta S, Deshmukh P. Predictor of low-birth-weight babies by anthropometry. J Tropical Pediatrics. 2007;53:420-3.

Mgeetha, B Kiran, S Santosh, A Correlation of Foot Length with Birth Weight, Indian Journal of Neonatal Medicine and Research. 2019;7(4):PO01-5.

Mathur A, Tak SK, Kothari P. Foot length - -A newer approach in neonatal anthropometry. J Trop Pediatrics. 1984;30:333-6.

Hirve SS, Ganatra BR. Foot tape measure for identification of low-birth-weight new-borns. Indian Pediatrics. 1993;30:25-29.

Marchant T, Jaribu J, Penfold S, Tanner M, Armstrong Schellenberg J. Measuring new-born foot length to identify small babies in need of extra care: A cross sectional hospital-based study with community follow-up in Tanzania. BMC Public Health. 2010;10:624.






Original Research Articles