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9. The Impact of Anthropomorphic measurement on child's health
Authors: (JAZGUL ABJAMILOVA [ https://orcid.org/0000-0001-8028-3343 ] , MD NAWAZ SHAHZADA KHAN ,KHADIJA ,IFRAHIM PAKEEZA,MAHMUDA PRODHANI ,)
Date: 23 October 2025
Scope: Neonatal period (birth → 28 completed days).
This paper synthesizes international clinical guidance and primary public-health data for Kyrgyzstan to present a comprehensive, evidence-based view of newborn anatomy & physiology, measurements, normal ranges, common problems (healthy vs. ill neonates) and public-health recommendations.
Newborn survival and health require understanding the unique anatomic and physiologic features of the neonate, routine measurements and thresholds, early recognition of danger signs, and timely interventions. Globally, prematurity, intrapartum-related events and neonatal infections are the leading causes of neonatal death; Kyrgyzstan shows similar patterns although substantial progress in neonatal mortality has been recorded in recent years. This paper reviews neonatal physiology (cardio-respiratory, thermoregulation, metabolic, renal, immune, neurologic), provides practical measurement ranges and red flags, summarizes congenital anomalies and screening tools, details routine newborn prophylaxis (vitamin K, BCG, HepB, eye prophylaxis) Kyrgyzstan-specific immunization and mortality data are presented and programmatic recommendations are offered to reduce neonatal morbidity and mortality.
The neonatal period (0–28 days) is the highest-risk timeframe in the life course for child mortality: nearly half of under-five deaths now occur in the neonatal period worldwide. Understanding normal neonatal biology and safe, high-impact interventions (skilled birth attendance, thermal care, early breastfeeding, birth-dose vaccines, timely management of sepsis and respiratory conditions) is essential for clinicians and public-health planners alike. Kyrgyzstan has recorded reductions in neonatal and infant mortality in the last decade but persistent regional differences and remaining causes—prematurity, intrapartum hypoxia, infection, and congenital anomalies—necessitate consolidated clinical and programmatic action. This paper compiles up-to-date guidelines and the latest country data to support clinicians, policy makers and researchers.
This cross-sectional observational study was conducted in the neonatal unit and included newborns within the first 48 hours of life, with parental consent obtained prior to participation. Critically ill neonates and those with major congenital anomalies were excluded. Anthropometric measurements (weight, length, head circumference, and chest circumference) were obtained using calibrated neonatal instruments; each measurement was recorded three times and averaged to reduce error. Physiological parameters, including axillary temperature, heart and respiratory rate, and neonatal reflexes, were assessed using standard clinical procedures. Data were recorded and analyzed using descriptive statistics in Microsoft Excel, and findings were compared against World Health Organization (WHO) neonatal growth standards and evidence-based neonatal care guidelines (WHO & UNICEF sources). Ethical approval was obtained from the institutional research committee, and all procedures followed ethical research standards, ensuring confidentiality and privacy of participant data.
1.1 Cardiovascular transition
● Fetal-to-neonatal transition: with lung aeration there is a fall in pulmonary vascular resistance, increased pulmonary blood flow, and functional closure (over hours–days) of fetal shunts (foramen ovale, ductus arteriosus). Newborn heart rate is substantially higher than older children; murmurs from transitional physiology are common and often transient.
1.2 Respiratory system
● Neonates breathe primarily diaphragmatically; respiratory pattern is frequently irregular with periodic breathing. Surfactant maturity is crucial — preterm infants lacking mature surfactant are at risk for respiratory distress syndrome (RDS). Transient tachypnea of the newborn (TTN) commonly follows cesarean delivery. Early respiratory adaptation determines oxygenation and perfusion during the first minutes and hours after birth.
1.3 Thermoregulation
● Neonates have a high surface area–to-mass ratio and limited subcutaneous fat (especially preterms), predisposing to heat loss and hypothermia. Non-shivering thermogenesis via brown adipose tissue and skin-to-skin (kangaroo) care are key heat-conservation strategies.
1.4 Metabolism and hepatic function
● Limited glycogen stores and immature gluconeogenesis predispose some neonates (preterm, SGA, infants of diabetic mothers) to hypoglycemia. Hepatic conjugation of bilirubin is immature
→ physiologic jaundice (peaks around days 2–5 in term infants) but can become pathologic if very early onset, rapidly rising, or associated with high bilirubin levels.
1.5 Renal & fluid balance
● Glomerular filtration rate (GFR) is low at birth and increases during the first weeks; urine output and electrolyte handling differ from older infants. Careful fluid management and surveillance for dehydration/overhydration are required.
1.6 Immune function
● Neonatal innate immunity is immature; passive transfer of maternal IgG (transplacental) provides partial protection for the first months. This immunologic vulnerability explains the nonspecific presentation of neonatal infections and the emphasis on prevention (clean delivery, vaccinations, early breastfeeding).
1.7 Neurologic status & reflexes
● Primitive reflexes (rooting, sucking, palmar/plantar grasp, Moro) are present in term infants and are indicators of neurologic integrity; absent or asymmetric reflexes prompt neurological
assessment and consideration of birth trauma, hypoxic ischemic encephalopathy (HIE) or congenital anomalies.
● Birth weight: mean term ≈ 3.2–3.4 kg; low birth weight <2.5 kg; very low birth weight <1.5 kg. Interpretation is gestational-age dependent; SGA defined as weight <10th percentile for GA. Use WHO/CDC growth charts for percentiles and z-scores.
● Crown-heel length: typical term 49–51 cm.
● Head circumference: term average ≈ 34–35 cm.
● Immediate postnatal weight loss of up to ~7–10% is expected in breastfed term infants during the first week.
(Use clinical context and activity: crying raises HR/RR; sleeping lowers them.)
● Heart rate (awake/active): commonly 110–160 beats/min; some references list ranges up to
~165. Tachycardia (>160 at rest) or bradycardia (<100–110) are concerning.
● Respiratory rate: 30–60 breaths/min (irregular). Sustained >60 with retractions/grunting suggests respiratory distress.
● Axillary temperature: target 36.5–37.5 °C; hypothermia (<36.0 °C) or fever (>38.0 °C) need evaluation.
● Blood pressure: systolic often 60–80 mmHg in immediate newborn period; age and weight dependent—interpret using reference charts.
● Oxygen saturation: low immediately after birth, with expected rise to >90–95% over the first 10 minutes in term neonates under normal transition (refer to neonatal resuscitation targets for
pre-ductal/post-ductal values).
Weight (kg) length (cm) Head circumferance ( cm ) Chest circumferance ( cm )
1. Head & Face
● Craniosynostosis – premature fusion of skull sutures.
● Microcephaly – small head size.
● Macrocephaly – abnormally large head.
● Cleft lip and/or cleft palate.
● Facial asymmetry due to nerve palsy.
● Ear deformities – microtia, low-set ears.
● Anophthalmia / Microphthalmia – absent or very small eyes.
2. Limbs & Skeletal System
● Polydactyly – extra fingers/toes.
● Syndactyly – fused fingers/toes.
● Clubfoot (talipes equinovarus).
● Congenital hip dislocation (Developmental dysplasia of the hip).
● Congenital bowing of tibia/femur.
● Absent limbs (amelia) or partial absence.
● Spina bifida – defect in vertebral column.
3. Chest & Cardiovascular
● Pectus excavatum – sunken chest.
● Pectus carinatum – pigeon chest.
● Congenital heart defects – VSD, ASD, tetralogy of Fallot.
● Large anterior fontanel or delayed closure (may indicate anomalies).
4. Abdomen & Gastrointestinal
● Omphalocele – abdominal organs herniate into a sac.
● Gastroschisis – intestine outside the abdomen without sac.
● Imperforate anus.
● Tracheoesophageal fistula.
● Hirschsprung disease – absence of ganglion cells in colon.
● Congenital diaphragmatic hernia.
5. Genitourinary System
● Hypospadias – urethral opening not at tip of penis.
● Epispadias.
● Ambiguous genitalia.
● Cryptorchidism – undescended testes.
● Renal agenesis / polycystic kidney.
● Bladder exstrophy.
6. Skin, Spine & Other
● Meningocele / Myelomeningocele.
● Birthmarks – hemangiomas, café-au-lait spots.
● Congenital scoliosis.
● Neural tube defects.
1.1 Common/physiologic:
● Peripheral acrocyanosis first 24–48 h; mild transient murmurs; physiologic jaundice onset after 24 h; vernix, lanugo in term/preterm variable.
1.2 Red flags requiring immediate assessment:
● Poor feeding/refusal to feed, lethargy/poor tone, temperature instability, central cyanosis, respiratory distress (grunting, retractions, persistent tachypnea), apnea >20 seconds or associated bradycardia, seizures, persistent vomiting, decreased urine output, bilious vomiting, jaundice within 24 hours or very high total bilirubin for age in hours. These may indicate sepsis, hypoglycemia, HIE, congenital heart disease, surgical abdomen, or severe hyperbilirubinemia.
1. Respiratory System
● Transient tachypnea of newborn (TTN).
● Respiratory distress syndrome (RDS) due to surfactant deficiency. in
● Apnea of prematurity.
● Meconium aspiration syndrome.
2. Cardiovascular Physiology
● Persistent pulmonary hypertension of the newborn (PPHN).
● Patent ductus arteriosus (physiologically abnormal if persistent).
● Transient murmurs due to delayed closure of fetal shunts.
3. Metabolic & Endocrine
● Hypoglycemia (common in IDM, preterm).
● Hypocalcemia / hypomagnesemia.
● Physiological jaundice (exaggerated form becomes pathological).
● Thyroid dysfunction (congenital hypothyroidism).
4. Neurological Physiology
● Hypoxic-ischemic encephalopathy (HIE).
● Seizures in newborns (subtle seizures).
● Hypotonia / hypertonia.
● Poor suck–swallow reflex.
5. Gastrointestinal Physiology
● Feeding intolerance.
● Gastroesophageal reflux.
● Delayed passage of meconium (may indicate physiological dysfunction).
6. Hematological Physiology
● Anemia of prematurity.
● Polycythemia.
● Hemolytic disease of newborn (Rh/ABO incompatibility).
● Prolonged bleeding due to vitamin K deficiency
2.1 Global context
● In 2023, an estimated 2.3 million newborns died in the first month of life worldwide. Leading global causes: prematurity, intrapartum-related events (birth asphyxia), neonatal infections (sepsis, pneumonia), and congenital anomalies. Most neonatal deaths occur within the first week and many within 24 hours of birth.
2.2 Kyrgyzstan
● UNICEF and national surveys document steady declines in neonatal and infant mortality in Kyrgyzstan over recent years. The UNICEF country data portal lists the neonatal mortality rate (NMR) ≈ 11 per 1,000 live births (most recent aggregated data shown on the UNICEF country page; annual estimates vary by source and year). Regional variation within Kyrgyzstan is marked
— some oblasts have achieved rapid declines (e.g., Jalal-Abad reported large improvement between 2018 and 2023). Primary causes recorded are similar to global: prematurity, birth asphyxia, infection and congenital anomalies.
● Major congenital anomalies of neonatal importance: critical congenital heart disease (CCHD), neural tube defects, orofacial clefts, limb defects, chromosomal abnormalities (e.g., Down syndrome) and a variety of metabolic or endocrine disorders detectable via newborn bloodspot screening (NBS). Pulse oximetry screening before discharge is an inexpensive screen for CCHD. Newborn bloodspot screening programs are uneven globally; Kyrgyzstan has registries and some regional programs but universal, extended NBS coverage is limited compared to high-income countries. Expansion of NBS and strengthening congenital anomaly surveillance are priority areas.
This study assessed the anatomical and physiological characteristics of newborns, focusing on key measurements such as weight, length, head circumference, and chest circumference. Most newborns fell within expected normal ranges, consistent with established neonatal growth standards. Minor variations observed were largely influenced by maternal, genetic, and birth-related factors. Common physiological adaptations such as molding and transient jaundice were noted, reflecting normal neonatal transition.
Although a few cases showed deviations requiring monitoring, overall findings highlight the importance of early screening and routine assessment to identify abnormalities and support healthy growth. Further research with a larger and more diverse sample is recommended.
This study was conducted on a limited sample of hospital-born newborns, which may not represent all populations. Data collection relied on manual anthropometric measurements and hospital records, introducing possible measurement and documentation bias. The research was cross-sectional and restricted to the early neonatal period; therefore, long-term developmental changes and late-appearing abnormalities could not be assessed. Maternal, genetic, and environmental factors were not studied in depth, which may influence newborn anatomical and physiological variations.
This study underscores the vital role of early anthropometric evaluation and physiological assessment in promoting healthy neonatal development. Most newborns demonstrated values within expected
WHO-referenced growth standards, emphasizing that simple, timely measurements—when performed accurately—serve as powerful tools in identifying deviations that may affect long-term health outcomes. As the neonatal period represents a critical window where rapid adaptation occurs, early detection of abnormalities enables prompt intervention, ultimately reducing preventable morbidity and mortality.
Strengthening neonatal screening, promoting standardized measurement practices, and increasing awareness among healthcare providers and families remain essential steps toward improving newborn survival and development. With continued integration of evidence-based WHO and UNICEF guidelines, alongside expanded research and follow-up studies, healthcare systems can ensure every child begins life with the healthiest foundation possible.
● WHO — Newborn health overview and programmatic recommendations.
● WHO — Recommendations for management of infants 0–59 days with serious bacterial infections (2024).
● WHO/UNICEF — Kyrgyzstan immunization country profile (immunization-2024-kgz.pdf).
● BC PEWS vital signs reference card (neonate vitals).
● WHO — Newborn infections and IMNCI training materials (management of sick young infants 0–59 days).
