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.
Affiliation: Medical Department, Médecins Sans Frontières, Geneva, Switzerland
Having obtained a diploma of medicine, anaesthesiology, intensive care and emergency medicine at the Catholic University of Louvain in Belgium, I also have a university degree in public health. After several missions as anaesthetist for MSF (Médecins Sans Frontières) in Bosnia and the Belgian Red Cross in Rwanda, I started working as field coordinator and medical coordinator with several MSF sections in Mauritania, Kenya, Soudan and Ethiopia. I took the position of hospital director for MSF in Jordan. Between missions I continue working as anaesthetist and emergency doctor in Belgium and France. Since more than 2 years I am the medical director’s deputy at headquarters of MSF Switzerland in Geneva.