Abstract
Objective:
To determine the accuracy and acceptability of a handheld scale prototype designed for nonliterate users to classify newborns into three weight categories (⩾2500 g; 2000 to 2499 g; and <2000 g).
Study Design:
Weights of 1100 newborns in Uttar Pradesh, India, were measured on the test scale and validated against a gold standard. Mothers, family members and community health stakeholders were interviewed to assess the acceptability of the test scale.
Result:
The test scale was highly sensitive and specific at classifying newborn weight (normal weight: 95.3 and 96.3%, respectively; low birth weight: 90.4 and 99.2%, respectively; very low birth weight: 91.7 and 98.4%, respectively). It was the overall agreement of the community that the test scale was more practical and easier to interpret than the gold standard.
Conclusion:
The BIRTHweigh III scale accurately identifies low birth weight and very low birth weight newborns to target weight-specific interventions. The scale is extremely practical and useful for resource-poor settings, especially those with low levels of literacy.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Save the Children Federation. World Health Organization 2001 estimates. In: Saving Newborn Lives, States of the World's Children. Save the Children: Washington, DC, 2001, pp 1–49.
Arisoy AE, Sarman G . Chest and mid-arm circumferences: identification of low birth weight newborn in Turkey. J Trop Pediatr 1995; 41: 34–37.
Bhargava SK, Ramji S, Kumar A, Mohan M, Marwah J, Sachdev HP . Mid-arm and chest circumferences at birth as predictors of low birth weight and neonatal mortality in the community. BMJ 1985; 291 (6509): 1617–1619.
WHO Collaborative Study of Birth Weight Surrogates. Use of a simple anthropometric measurement to predict birthweight. Bull World Health Organ 1993; 71: 157–163.
Dusitsin N, Compootaweep S, Poomsuwan P, Dusitsin K, Sentrakul P, Lumbiganond P . Development and validation of a simple device to estimate birthweight and screen for low birthweight in developing countries. Am J Public Health 1991; 81: 1201–1205.
De Vaquera MV, Townsend JW, Arroyo JJ, Lechtig A . The relationship between arm circumference at birth and early mortality. J Trop Pediatr 1983; 29: 167–174.
Hossain MM, Habib M, DuPont HL . Association between birth weight and birth arm circumference of neonates in rural Egypt. Indian J Pediatr 1994; 61: 81–87.
Huque F, Hussain AM . Detection of low birth-weight newborn babies by anthropometric measurements in Bangladesh. Indian J Pediatr 1991; 58: 223–231.
Kapoor SK, Kumar G, Anand K . Use of mid-arm and chest circumferences to predict birth weight in rural north India. J Epidemiol Comm Health 1996; 50: 683–686.
Rogo K, Nyagudi O, Ferguson A . A study of mid-arm and chest circumferences as predictors of low birth weight. Int J Gynecol Obstet 1991; 34: 107–113.
Singh M, Paul VK, Deorari AD, Anandalakshmi PN, Sundaram KR . Simple tricoloured measuring tapes for identification of low birthweight babies by community health workers. Ann Trop Pediatr 1988; 8: 87–91.
Ngowi JA, Redding-Lallinger R, Hirji KF . An assessment of the use of anthropometric measures for predicting low birth weight. J Trop Pediatr 1993; 39: 356–360.
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 newborns of Sarlahi, Nepal. Eur J Clin Med 2007; 61 (1): 40–46.
Das JC, Afroze A, Khanam ST, Paul N . Mid-arm circumference: an alternative measure for screening low birth weight babies. Bangladesh Med Res Counc Bull 2005; 31: 1–6.
Nair RB, Elizabeth KE, Geetha S, Varghese S . Mid arm circumference (MAC) and body mass index (BMI)—the two important auxologic parameters in neonates. J Trop Pediatr, print copy in press (originally published online May 30 2006 at http://tropej.oxfordjournals.org/cgi/rapidpdf/fml023.
Figuiera BB, Segre CA . Mid-arm circumference and mid-arm/head circumference ratio in term newborns. Sao Paulo Med J 2004; 122: 53–59.
Sharma JN, Saxena S, Sharma U . Thigh circumference at birth as the best predictor of low birth weight babies. Indian Pediatr 1989; 26: 18–21.
Gupta V, Hatwal SK, Mathur S, Tripathi VN, Sharma SN, Saxena SC et al. Calf circumference as a predictor of low birth weight babies. Indian Pediatr 1996; 33: 119–121.
Hirve SS, Ganatra BR . Foot tape measure for identifying low birth weight newborns. Indian Pediatr 1993; 30: 25–29.
Harrison G, Galal OM, Salem SI, Gabr AA, Kalla KA . Field evaluation of three scales for identification of low birthweight infants by traditional and paraprofessional practitioners in Egypt. Final report submitted to PATH by the UCLA School of Public Health and the National Research Center, Cairo, December, 1992.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L . Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365 (9463): 977–988.
Darmstadt GL, Kumar V, Yadav R, Singh V, Singh P, Mohanty S et al. Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. J Perinatol 2006; 26 (10): 597–604.
Yasmin S, Osrin D, Paul E, Costello A . Neonatal mortality of low birth weight infants in Bangladesh. Bull World Health Organ 2001; 79: 608–614.
Pratinidhi A, Shah U, Shrotri A, Bodhani N . Risk-approach strategy in neonatal care. Bull World Health Organ 1986; 64 (2): 291–297.
Bang AT, Bang RA, Reddy MH, Baitule SB, Deshmukh MD, Paul VK et al. Simple clinical criteria to identify sepsis or pneumonia in neonates in the community needing treatment or referral. Pediatr Infect Dis J 2005; 24: 335–341.
Bang AT, Reddy HM, Deshmukh MD, Baitule SB, Bang RA . Neonatal and infant mortality in the ten years (1993–2003) of the Gadchiroli field trial: effect of home-based neonatal care. J Perinatol 2005; 25 (Suppl 1): S92–S107.
Datta N . Acute respiratory infection in low birth weight infants. Indian J Pediatr 1987; 54: 171–176.
Daga SR, Daga AS . Reduction in neonatal mortality with simple interventions. J Trop Pediatr 1989; 35: 191–196.
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: 410–413.
Rahmathullah L, Tielsch JM, Thulasiraj RD, Katz J, Coles C, Devi S et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ 2003; 327 (7409): 254–259.
White SA, van den Broek NR . Methods for assessing reliability and validity for a measurement tool: a case study and critique using the WHO haemoglobin colour scale. Statist Med 2004; 23: 1603–1619.
Acknowledgements
Support for the study was provided by the Saving Newborn Lives program of Save the Children—US, through a grant from the Bill & Melinda Gates Foundation. Support for the main trial in which this study was nested came from the United States Agency for International Development (USAID) India (New Delhi) Mission, through grants HRN-A-00-96-90006-00, Family Health and Child Survival Cooperative Agreement and GHS-A-00-03-00019-00, Global Research Activity Cooperative Agreement to Johns Hopkins University; and Save the Children—US through a grant from the Bill & Melinda Gates Foundation. We thank Luke Mullany of Johns Hopkins University for advice on statistical analyses. The Birthweigh scale was originally designed and developed under the HealthTech program, supported by USAID and managed by PATH. PATH redesigned the BIRTHweigh scale in consultation with study investigators, Gary Darmstadt and Vishwajeet Kumar, along with Luke Mullany, and produced and provided the prototypes for this study. We also thank Jessica Fleming at PATH for assistance with training of project workers on use of the scale. Developers of the Birthweigh III scale at PATH included Yancy Seamans, Bill Van Lew and Glenn Austin.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Darmstadt, G., Kumar, V., Shearer, J. et al. Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India. J Perinatol 27, 602–608 (2007). https://doi.org/10.1038/sj.jp.7211797
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211797
Keywords
This article is cited by
-
Birthweight, gestational age, and early school trajectory
BMC Public Health (2023)
-
Newborn low birth weight: do socio-economic inequality still persist in India?
BMC Pediatrics (2021)
-
Neonatal hypothermia in low resource settings: a review
Journal of Perinatology (2009)
-
Community perceptions of birth weight in rural Uttar Pradesh, India: implications for care of low-birth-weight infants
Journal of Perinatology (2008)