Nutrition-specific and nutrition-sensitive factors associated with mid-upper arm circumference as a measure of nutritional status in pregnant Ethiopian women: Implications for programming in the first 1000 days

Ghosh, Shibani; Spielman, Kathryn; Kershaw, Meghan; Ayele, Kidane; Kidane, Yitbarek; Zillmer, Krista; Wentworth, Leslie; Pokharel, Ashish; Griffiths, Jeffrey K.; Belachew, Tefera; Kennedy, Eileen

doi:10.1371/journal.pone.0214358

“…This study also revealed that per one-centimeter increment of maternal mid-upper arm circumference measurement increases the mean hemoglobin level of a woman by 0.14 g/dl. The current finding was supported by the studies conducted in the urban area of Eastern Ethiopia [28], the Rural part of Jigjiga [29], pregnant women of Ethiopia [43], and Rural Oromia residents [25]. This might be because of the reason that undernourished pregnant women had a higher probability of being micronutrient deficient and anemic [44].…”

Section: Biomed Research Internationalsupporting

confidence: 77%

Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia

Kuma

¹

,

Tamiru

²

,

Belachew

³

2021

BioMed Research International

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Background. Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Methods. A community-based cross-sectional study design was carried out among 367 pregnant women from June 1 to 30, 2020. Systematic random sampling was used to select study subjects. Hemoglobin level was measured by using HemoCue HB 301. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the linearity, normality, multicollinearity, and homoscedasticity assumptions were checked. The unstandardized beta ( β ) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependant variables. Statistical significance was declared at P value < 0.05. Results. The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia ( hemoglobin level < 11 g / dl ) among pregnant women was found to be 85 [23.16%, (95% CI: 18.3%-27.5%)]. Meal frequency [ β = 0.40 , (95% CI: 0.12, 0.69), P = 0.005 ], interpregnancy interval [ β = 0.08 , (95% CI: 0.02, 0.15), P = 0.007 ], mid-upper arm circumference measurement [ β = 0.13 , (95% CI: 0.07, 0.20), P ≤ 0.001 ], own fruits/vegetable [ β = 0.55 , (95% CI: 0.79, 0.31), P ≤ 0.001 ], coffee consumption [ β = − 1.00 , (95% CI: -1.31, -0.68), P ≤ 0.001 ], and having history of still birth [ β = − 0.63 , (95% CI: -1.06, -0.20), P = 0.004 ] were significantly associated with the hemoglobin level of pregnant women. Conclusions. Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, promotion of fruits/vegetable consumption, and improving the nutritional status of the women during antenatal care follow-up. Moreover, early screening and management of women with a history of stillbirth for anemia are also essential.

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“…The other variables did not have a significant influence on the MUAC.In our study, the DDS was negatively correlated with the MUAC. Similarly, Ghosh and his colleagues in their study, found that having a high DDS did not have a positive increase on the MUAC[34]. In this study, the DDS could have been negatively correlated with MUAC as the 24-hour dietary recall may not -sectional study in Bangladesh in both male and female adults showed that there was a positive linear correlation between MUAC and the Body Mass Index…”

supporting

confidence: 46%

Assessing Malnutrition in Pregnant Women Using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A Cross-Sectional Study, Zambia

Mayimbo¹,

Haruzivishe²,

Kwaleyela³

et al. 2020

FNS

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The dietary diversity score (DDS) and the mid-upper arm circumference (MUAC) can be used to assess nutritional status. The DDS is a qualitative measure of food consumption reflecting an individual's access to different food items and therefore a proxy indicator of the nutritional status. The aim of the study was to assess whether the dietary diversity score and MUAC can be used to assess the nutritional status of pregnant women attending antenatal. A cross-sectional survey was conducted at Chilenje level I Hospital in a township located in Lusaka city, Lusaka province. The study employed quantitative methods to collect and analyse data on the dietary patterns of individuals in the previous 24 hours before the survey. Health facilities were randomly selected and systematic sampling was used to select a sample of 299 pregnant women. An interview schedule was used to collect data. Median and interquartile range were used to compare demographic data. Spearman's Correlation for two continuous variables was used to establish associations between DDS and the MUAC. The median age was 27 years. About 44% of the women were in the lowest dietary diversity category, indicating inadequate nutrient intake, 31% in the medium category and 24% in the high intake. Dietary diversity score was negatively correlated with mid-upper arm circumference (p = 0.1295

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“…In our study, the DDS was negatively correlated with the MUAC. Similarly, Ghosh and his colleagues in their study, found that having a high DDS did not have a positive increase on the MUAC (36) . In this study, the DDS could have been negatively correlated with MUAC as the 24-hour dietary recall may not give a true re ection of the daily food intake of the participants.…”

Section: Discussionmentioning

confidence: 73%

Assessing malnutrition in pregnant women using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A cross-sectional study, Zambia

Mayimbo

¹

,

Haruzivishe

²

,

Kwaleyela

³

et al. 2020

Preprint

0

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Background One of the easiest and effective ways of predicting under nutrition is to use the Dietary Diversity Score (DDS) and the mid-upper arm circumference (MUAC). The dietary diversity score is a qualitative measure of food consumption reflecting an individual’s access to different food items and therefore is a proxy indicator of the nutritional status. The aim of the study was to assess whether the DDS and MUAC can be used to assess the nutritional status of pregnant women attending antenatal. Methods A cross-sectional survey was conducted at Chilenje level I Hospital in a township located in Lusaka city, Lusaka province. The study employed quantitative methods to collect and analyse data on the dietary patterns and if this can be used to assess the nutritional status of individuals 24 hours preceding the survey. Health facilities were selected using random sampling method and systematic sampling method was used to select a sample of 299 pregnant women. An interview schedule was used to collect data. Logistic regression was used to establish associations between DDS and MUAC. Results In this study, 44% of the women were in the lowest dietary diversity category, which indicates inadequate nutrient intake, 31% in the medium category and 24% in the high intake. Maternal weight was associated with a 0.08 cm increase in MUAC (95% CI; 0.74 – 0.93) and this was statistically significant. Marital status and age (95% CI; 0.83 – 0.93) were significantly associated with an increase in MUAC in the univariate analysis but when adjusted for other confounders this was not significant (95% CI; 0.81 – 1.00). Consumption of organ meat was associated with a 0.21cm increase in MUAC (95% CI; 0.04 - 0.97). Conclusion The study results indicated that 44% of the women had inadequate nutrient intake, indicating that the dietary diversity score can be used to predict malnutrition in pregnant women. The mid upper was negatively correlated with the 24hour dietary diversity score implying that we might not rely on this measurement to assess the nutritional status. Key words Dietary Diversity Score, Malnutrition, Mid Upper Arm Circumference, Pregnant women, Antenatal.

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Nutrition-specific and nutrition-sensitive factors associated with mid-upper arm circumference as a measure of nutritional status in pregnant Ethiopian women: Implications for programming in the first 1000 days

Cited by 31 publications

References 32 publications

Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia

Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia

Assessing Malnutrition in Pregnant Women Using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A Cross-Sectional Study, Zambia

Assessing malnutrition in pregnant women using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A cross-sectional study, Zambia

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