Proposal of MUAC as a fast tool to monitor pregnancy nutritional status: results from a cohort study in Brazil

• Published in: BMJ open 2021-05, Vol.11 (5), p.e047463
• Main Authors: Miele, Maria J, Souza, Renato T, Calderon, IMP, Feitosa, Francisco, Leite, Debora F, Rocha Filho, Edilberto, Vettorazzi, Janete, Mayrink, Jussara, Fernandes, Karayna G, Vieira, Matias C, Pacagnella, Rodolfo C, Cecatti, Jose Guilherme
• Format: Article
• Language: English
• Subjects: Anthropometry; Arm - anatomy & histology; Body Mass Index; Brazil; Classification; Cohort analysis; Cohort Studies; Female; Hospitals; Humans; Infant, Newborn; Malnutrition; Medical diagnosis; Medical personnel; Nutritional Status; Obstetrics and Gynaecology; Pregnancy; Prenatal care; Research methodology; Risk assessment; Womens health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-047463

ObjectiveIn Brazil, although the assessment of maternal nutritional status is recommended using body mass index (BMI), this is only possible in settings adequately prepared. Midupper arm circumference (MUAC) is another biological variable identified as a tool for rapid assessment of nutritional status that is correlated with BMI. Therefore, we aim to surrogate BMI by MUAC cut-offs for rapid screening of maternal nutritional status starting at midpregnancy.DesignAnalysis of the multicentre cohort study entitled ‘Preterm SAMBA’ using an approach of validation of diagnostic test.SettingOutpatient prenatal care clinics from five tertiary maternity hospitals from three different Brazilian regions.Participants1165 pregnant women attending prenatal care services from 2015 to 2018 and with diverse ethnic characteristics who were enrolled at midpregnancy and followed in three visits at different gestational weeks.Primary and secondary outcome measuresSensitivity, specificity, positive and negative predictive values, likelihood ratio and accuracy of MUAC being used instead of BMI for the assessment of nutritional status of women during pregnancy.ResultsWe found a strong correlation between MUAC and BMI, in the three set points analysed (r=0.872, 0.870 and 0.831, respectively). Based on BMI categories of nutritional status, we estimated the best MUAC cut-off points, finding measures according to each category: underweight 30.15 cm (19–21 weeks), >30.60 cm (27–29 weeks) and >30.25 cm (37–39 weeks) per gestational week. Therefore, we defined as adequate between 25.75–28.10 cm (19–21 weeks), 25.75–28.70 cm (27–29 weeks) and 25.75–29.45 cm (37–39 weeks) of MUAC.ConclusionWe conclude that MUAC can be useful as a surrogate for BMI as a faster screening of nutritional status in pregnant women.