A Cross-sectional Study to Determine the Nutritional Status of Pregnant Women using Mid-upper Arm Circumference and Neck Circumference

Abstract Background: Assessment of maternal nutritional status in the second and third trimesters of pregnancy is challenging. Mid-upper arm circumference (MUAC) and neck circumference (NC) can be used for nutritional assessment of pregnant women in the second and third trimester. Materials and Methods: A cross-sectional study was conducted among 646 pregnant women in a teaching hospital in South India after ethics approval. Height, MUAC, and NC were primary data, and the weight of the first trimester was collected from patient files. The Youden Index was used to identify the best cut-offs for MUAC and NC for underweight and obesity as per the WHO classification for body mass index (BMI). Results: Mean (standard deviation) first-trimester BMI was 21.5 kg/m 2 (4.5), and that of MUAC, NC were 155.4 cm (5.2), 25.5 cm (2.5), and 30.2 cm (2.9), respectively. Using the first-trimester BMI, one in four antenatal women was underweight, and 23 were identified as obese. For underweight (BMI < 18.5 kg/m 2 ), the best sensitivity and specificity of MUAC was 23.5 cm, and for obesity (BMI ≥ 30 kg/m 2 ), it was 29.5 cm. Similarly, for NC, the values were 28.5 cm and 34.5 cm, for underweight and obesity, respectively. Using these cut-offs for MUAC, 154 (23.8%) participants were thin, 36 (5.6%) were obese, and using the NC cut-offs, 194 (30%) women were thin, and 59 (9.1%) women were obese. Conclusion: MUAC and NC can be useful tools in screening for underweight and obesity, which can be starting points for further physical and biochemical assessments in pregnant women.