title: Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context?
abstract: Currently there is no consensus on how to identify pregnant women as acutely malnourished and when to enroll them in nutritional programmes. Médecins Sans Frontières Switzerland undertook a literature review with the purpose of determining values of anthropometric indicators for acute malnutrition that are associated with adverse birth outcomes (such as low birth weight (LBW)), pre-term birth and intra-uterine growth retardation (IUGR). A literature search in PUBMED was done covering 1 January 1995 to 12 September 2012 with the key terms maternal anthropometry and pregnancy. The review focused on the humanitarian context. Mid-upper-arm circumference (MUAC) was identified as the preferential indicator of choice because of its relatively strong association with LBW, narrow range of cut-off values, simplicity of measurement (important in humanitarian settings) and it does not require prior knowledge of gestational age. The MUAC values below which most adverse effects were identified were <22 and <23 cm. A conservative cut-off of <23 cm is recommended to include most pregnant women at risk of LBW for their infants in the African and Asian contexts.
authors.affiliation: Medical Department, Médecins Sans Frontières, Geneva, Switzerland.
authors.forename: Mija-Tesse
authors.initials: MT
authors.lastname: Ververs
authors.forename: Annick
authors.initials: A
authors.lastname: Antierens
authors.forename: Anita
authors.initials: A
authors.lastname: Sackl
authors.forename: Nelly
authors.initials: N
authors.lastname: Staderini
authors.forename: Valerie
authors.initials: V
authors.lastname: Captier