This investigation describes the pattern of changes in mid-upper arm circumference (MUAC), triceps, biceps and subscapular skinfold thicknesses during the course of pregnancy, and its relationship with maternal and newborn outcomes. A prospective cohort of 1066 pregnant women were selected in seven different urban regions in Argentina. Measurements of MUAC were carried out at 16, 28 and 36 gestational weeks. In a subsample of 488 women, triceps, biceps and subscapular skinfold thicknesses were measured. Mean total increase in subscapular, tricipital and bicipital skinfolds from 16 to 36 weeks of gestation were 4.5, 3.6 and 2.6 mm, respectively. MUAC showed a mean increase of 1.7 cm in the same period. Overweight or obese women at the start of pregnancy had lower increases in all measurements compared with women with normal or low body mass index. Maternal anthropometry was related to birthweight; women who gave birth to infants of less than 3000 g had lower average values in all measurements than those who had normal birthweight infants. LMS curves for MUAC and skinfolds by gestational age are presented, which can be used as a reference to assess maternal nutrition status during pregnancy. MUAC, tricipital and subscapular skinfold for gestational age curves are proposed for monitoring maternal nutritional status during pregnancy. MUAC cut-off points of 24.5, 25.5 and 26.5 cm for 16, 28 and 36 weeks of gestation, respectively, are also proposed as a proxy to detect low birthweight.

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This BMI for gestational age chart, based on women who delivered normal birth weight infants and processed with modern statistical methods, represents an improvement in pre-natal care monitoring.

Argentina has been largely considered as having an adequate diet in terms of iron availability. However, children aged 9-24 mo do not meet requirements from their regular diet. The aim of this study was to assess the incidence of iron deficiency in a representative sample of children living in Greater Buenos Aires. Hematologic indicators were measured in venous blood from 384 children. Weighted incidence of anemia was 46.7%. Mean corpuscular volume was less than 73 fL in 28.2% of subjects, free erythrocyte protoporphyrin was greater than 1.77 mumol/L erythrocytes in 57.1%, and serum ferritin was less than 12 micrograms/L in 60.2%.incidence of two or three abnormal values for iron status indicators was 46.1%. This extremely high incidence of anemia is associated with low iron intakes (5.6 +/- 3.5 mg/d means +/- SD), early introduction of cow milk, and low consumption of iron-fortified foods and iron supplements.

Impact of folic acid fortification on women nutritional status and on the prevalence of neural tube defects Introduction: In 2003 iron and folic acid fortification of wheat flour became mandatory in Argentina. Folate nutritional status was assessed in a national probabilistic sample of women 10-49 years old and pregnant women. Changes in the prevalence of neural tube defects (NTDs) were evaluated before and after fortification. Population and Methods: Data from the National Nutritional and Health Survey done in 2005 were used for folate intakes (24 h dietary recall) and serum levels. Fetal and infant mortality rates for NTDs were assessed in the period 2000-2006 from Vital Statistics Series, based on birth and death certificates. Prevalence of NTDs in hospital discharge statistics were analyzed in the pre and post fortification period. Results: Median folate intakes were 532 and 821 µg/ day in women 10-49 years-old and pregnant women, respectively. In both groups, folic acid from wheat flour represented 245 and 331 µg/day. Serum folate was assessed in 5,322 women 10-49 years old and in 1,321 pregnant women. Prevalence of serum folate concentration < 3 ng/mL was 0.8% in women of child-bearing age and 2.7% in pregnant women. Mortality rate due to anencephaly in 2000-2003 was 53.1 per 100.000 births and decreased to 23.3 per 100.000 births in 2005-2006. Spina bifida mortality rate decreased 67% in the same period. In a similar way, hospital discharge statistics showed a decrease of 54% for anencephaly, 33% for encephalocele, and 45% for spina bifida between 2000 and 2005. Conclusions: Food fortification with folic acid was associated with adequate intakes and serum folate levels in women. Concurrently, NTDs prevalence and mortality showed a significant reduction.