The performance of various anthropometric assessment methods for predicting low birth weight in pregnant women

Abstract

O b j e c t i v e s : t o a s s e s s t h e p e r f o r m a n c e o f v a r i o u s anthropometric methods for the evaulation of the nutritional status of pregnant women as a means of predicting low birth weight (LBW). M e t h o d s : a d e s c r i p t i v e c ro s s -c u t t i n g s t u d y c a r r i e d out among 433 pregnant women (≥20 years) attending a Public Maternity Hospital in Rio de Janeiro, Brazil. The adequacy of the weight gain at the end of the pregnancy w a s e v a l u a t e d i n a c c o rd a n c e w i t h t h e p ro p o s a l s o f t h e I n s t i t u t e o f M e d i c i n e a n d t h e B r a z i l i a n M i n i s t r y o f H e a l t h . T h e s e n s i t i v i t y, s p e c i f i c i t y a n d a c c u r a c y o f t h e adequacy of weight gain at the end of the pregnancy or n u t r i t i o n a l s t a t e o f m o t h e r a s a p re d i c t o r o f l o w b i r t h weight were calculated.Results: the sensitivity of the various methods varied from 63.1% to 68.4% and the specificity from 71.2% to (OR=4.10; 75.1%. The adapted Institute of Medicine proposal drawn up by the Brazilian Ministry of Health, according to the classification of the pre-delivery nutritional status of the mother according to the World Health Organization cutoff points showed itself to be the most accurate (74.5%), t h i s b e i n g t h e m o s t a d e q u a t e m e t h o d f o r n u t r i t i o n a l triage for reason of its association with low birth weight Resumo O b j e t i v o s : a v a l i a r o d e s e m p e n h o d e d i f e re n t e s métodos antropométricos para avaliação nutricional de gestantes para predizer o baixo peso ao nascer (BPN). Métodos: estudo descritivo do tipo transversal, real i z a d o c o m 4 3 3 p u é r p e r a s ( ≥ 2 0 a n o s ) a t e n d i d a s n u m a M a t e r n i d a d e P ú b l i c a d o R i o d e J a n e i ro , B r a s i l . A a d e q u a ç ã o d o g a n h o d e p e s o a o f i n a l d a g e s t a ç ã o f o i avaliada segundo as propostas do R e s u l t a d o s : a s e n s i b i l i d a d e d o s m é t o d o s v a r i o u d e 63,1% a 68,4% e a especificidade de 71,2% a 75,1%. A a d a p t a ç ã o d a p ro p o s t a d o I n s t i t u t e o f M e d i c i n e e l a b orada pelo Ministério da Saúde, segundo a classificação d o e s t a d o n u t r i c i o n a l p r é -g e s t a c i o n a l p e l o s p o n t o s d e c o r t e d a O rg a n i z a ç ã o M u n d i a l d a S a ú d e a p re s e n t o u m a i o r a c u r á c i a ( 7 4 , 5 % ) , s e n d o e s t e ú l t i m o o m a i s adequado para triagem nutricional pela sua associaçãocom o BPN (OR=4,10; IC95%=1,92

The performance of various anthropometric assessment methods for predicting low birth weight in adolescent pregnant women

“…In addition to the above, the most used recommendations for weight gain planning during pregnancy 7,13,18 were not validated according to the prenatal results of adolescent. Thus, the investigation on the best gestational anthropometric evaluation method, especially in teenagers, needs to be encouraged, and the topic should be discussed by researchers and professionals in the evaluation of prenatal care quality 1 . These methods are expected to present good sensitivity and specificity to classify, appropriately, the maternal nutritional status and to identify the risk situations for an unwanted obstetric outcome in pregnant adolescents 17 .…”

“…Epidemiological studies show that the inadequacy of the anthropometric state of women, before and during pregnancy, constitutes a public health problem by promoting the development of gestational intercurrences and influencing their health conditions in the postpartum and conceptus periods 1,2 . Developing countries have been showing distinct situations of nutritional deviation problems: a decline in malnutrition and an increase in overweight, obesity and chronic diseases [3][4][5] .…”

Performance of an anthropometric assessment method as a predictor of low birthweight and being small for gestational age

“…Padilha et al . () conducted the first study in Brazil on the performance evaluation of the main methodologies used for the anthropometric assessment of pregnant women. It was emphasised that the rate of low pre‐pregnancy weight was reduced, whereas the rate of overweight increased, according to the pre‐pregnancy categorisation proposed by the World Health Organization (), similar to the new IOM recommendation for the classification of pre‐pregnancy nutritional status.…”

“…Anthropometric measurements are the most important methods used for nutritional monitoring of pregnant women as a result of their recognised importance in the prevention of perinatal morbidity and mortality, prognosis of health status of the newborn and promotion of women's health (World Health Organization, ; Padilha et al ., ; Nunes et al ., ; Skouteris et al ., ; Magann et al ., ).…”

“…The Brazilian Ministry of Health (MH) has adopted international recommendations for the anthropometric assessment of Brazilian pregnant women. Since 2004, the MH has recommended the use of IOM guidelines (Institute of Medicine, , ) in Brazil (Padilha et al ., ; Simas et al ., ). This proposal has been validated in a low birthweight outcome in a case study referring to pregnant adults treated at Rio de Janeiro health centres, based on the categorisation of pre‐pregnancy nutritional status according to WHO recommendations (World Health Organization, ; Padilha et al ., ).…”