Undernutrition Using the Mid Upper Arm Circumference among Pregnant Women and Its Predictors in Delhi, India: A Facility-Based Study

Abstract

Background: Maternal undernutrition is a major public health challenge in developing countries linked with adverse pregnancy and birth outcomes. The study objective was to determine the prevalence of maternal undernutrition and assess the validity of the mid upper arm circumference (MUAC) method for the detection of undernutrition in pregnant women. Methods: This secondary data analysis was based on the data collected from antenatal women irrespective of gestational age recruited at two clinic sites in government hospitals of Delhi, India from February to June 2020. Results: A total of 69 (5.3%), 426 (32.6), and 811 (62.1%) women in their first, second, and third trimester of pregnancy, respectively, were enrolled (n = 1306). The mean (SD) age of the participants was 24.9 (3.9) years. The prevalence of undernutrition considering MUAC <23 cm was 21.5% (95% CI: 19.3-23.8). On adjusted analysis, age <30 years, Hindu religion correlating with vegetarian diet and lower educational status were significantly associated with higher odds of maternal undernutrition. Diagnostic accuracy for detecting maternal undernutrition using MUAC with cutoff <23 cm and body mass index (BMI) of <18.5 kg/m2 as the gold standard showed r = 0.36, P < 0.001 and kappa value, κ = 0.293, P < 0.001 indicating significant agreement. Maternal undernutrition was also a statistically significant predictor of low BMI, anemia, and low birth weight among newborn (P < 0.001). Conclusion: Nearly one in five pregnant women were undernourished in government health facilities in Delhi. Furthermore, the MUAC is a low-cost appropriate technology for identifying undernutrition among pregnant women and predictor of low-birth weight in the newborn in primary health-care settings.