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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Performance of an anthropometric assessment method as a predictor of low birthweight and being small for gestational
P de Carvalho Padilha1,2, D C Barros2,3, A B F Campos2
1Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Insights
The Institute of Medicine's 2009 method for assessing pregnant women's weight gain effectively predicts low birthweight and small for gestational age (SGA) outcomes, especially with insufficient weight gain. It also shows intermediate sensitivity for predicting large for gestational age (LGA) and complications.
Area of Science:
- Maternal-Fetal Medicine
- Nutritional Science
- Public Health
Background:
- Evaluating the 2009 Institute of Medicine (IOM) recommendations for anthropometric assessment in pregnant women.
- Assessing the predictive performance of the IOM method for key perinatal outcomes.
- Focusing on birthweight adequacy, gestational age-appropriate growth (SGA, LGA), and pregnancy/neonatal complications.
Purpose of the Study:
- To determine the efficacy of the 2009 IOM method in predicting perinatal outcomes.
- To analyze the relationship between maternal weight gain adequacy and adverse perinatal results.
- To provide evidence for refining nutritional guidelines in prenatal care.
Main Methods:
- Cross-sectional study of 827 postpartum women in Rio de Janeiro.
- Data collected via interviews and medical record review.
- Logistic regression analysis to estimate Odds Ratios (OR) and 95% Confidence Intervals (CI) for predicting outcomes based on weight gain adequacy.
Main Results:
- 36.2% of women began gestation with weight deviations.
- Prevalence of outcomes: 4.6% low birthweight, 3.7% SGA, 5.7% LGA, 45.2% pregnancy complications, 15.2% neonatal complications.
- Insufficient weight gain significantly correlated with increased risk of low birthweight (OR=3.76) and SGA (OR=5.77), and gestational complications (OR=1.72).
Conclusions:
- The evaluated IOM method shows higher sensitivity and specificity for predicting outcomes linked to insufficient maternal weight gain (low birthweight, SGA).
- The method demonstrates intermediate sensitivity in predicting outcomes related to excessive fetal growth (LGA) and associated complications.
- Findings support the utility of the 2009 IOM guidelines for identifying high-risk pregnancies based on weight gain patterns.
Background:
The present study aimed to evaluate the performance of the method proposed in 2009 by the Institute of Medicine for the anthropometric assessment of pregnant women, predicting perinatal outcomes: adequacy of birthweight, adequacy of birthweight according to gestational age [small for gestational age (SGA), large for gestational age (LGA)] and gestational and neonatal complications.
Methods:
The study comprised a cross-sectional study involving 827 post-partum women (>20 years) who were treated in a public maternity hospital in the city of Rio de Janeiro. Data collection occurred by interviews and record consultation. Adequacy of weight gain during pregnancy was determined as being insufficient and excessive for the recommended range according to nutritional status category. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for logistic regression.
Results:
Some 36.2% of women initiated gestation with some weight deviation. The prevalence of the outcomes studied was 4.6% (n = 35) for low birthweight, 3.7% (n = 31) for SGA, 5.7% (n = 47) for LGA, 45.2% (n = 374) for pregnancy complications and 15.2% (n = 85) for neonatal complications. For women with insufficient weight gain, the new recommendation indicated a correlation in the prediction of low birthweight (OR = 3.76, 95% CI = 1.53-9.21), SGA newborns (OR = 5.77, 95% CI = 2.10-15.8) and gestational complications (OR = 1.72, 95% CI = 1.20-2.48).
Conclusions:
The method evaluated demonstrated a better sensitivity and specificity for the main outcomes related to insufficient weight gain (low birthweight and SGA). Regarding excessive foetal growth (LGA), gestational and neonatal complications demonstrated sensitivity for an intermediate value.
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