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  • Title: Newborn's arm circumference as a screening tool of low birth weight in Temeke District, Dar es Salaam, Tanzania.
    Author: Ramaiya C, Msamanga G, Massawe S, Mpanju W, Ngwalle E.
    Journal: Trop Geogr Med; 1994; 46(5):318-21. PubMed ID: 7855921.
    Abstract:
    To determine the extent to which newborn's mid-upper-arm circumference (MUAC) could be used as a screening tool for low birth weight (LBW), we examined a total of 601 full-term singleton babies delivered at Temeke District Hospital in Dar es Salaam, Tanzania, between January and April 1992. The mean birth weight and standard deviation (SD) was 2826 (+/- 436) g and the MUAC (SD) 9.9 (+/- 0.8) cm with a correlation coefficient of 0.88 between MUAC and birth weight (p = 0.0001). The percentage of LBW (< 2500 g) and an arm circumference below 9.5 cm were 18.8% and 11.8%, respectively. Use of 9.5 cm measurement as a cut-off point in MUAC was found to be a significant predictor of low birth weight. The sensitivity, specificity and positive predictive value were 57.5%, 98.8% and 91.6%, respectively. Newborns with a mid-upper-arm circumference < 9.5 cm were 10 times more likely to have a LBW compared with an arm circumference > or = 9.5 cm (p = 0.0001). In places where the conventional scales are not readily available MUAC of 9.5 cm could be used as a method to screen LBW babies in Tanzania. Significant maternal factors associated with LBW at the first antenatal clinic (ANC) booking included: weight < 43.5 kg, height < 150 cm, age of 14 to 19 years, positive malaria parasitemia and previous history of LBW. It is recommended that subjects with the above risk factors at ANC booking should be advised to deliver in hospital. In Tanzania, health workers compared the birth weight of 627 newborns delivered at Temeke District Hospital in Dar es Salaam during January-April 1992 with their mid-upper-arm circumference (MUAC) to determine whether the MUAC could be used as an indicator of low birth weight (LBW) (2500 g) among newborns. The birth weight ranged from 1000 to 4400 g. The MUAC ranged from 7.5 to 13 cm. Around 18.8% of the newborns were LBW. 11.8% had an MUAC less than 9.5 cm. The researchers determined that 9.5 cm is the cut-off point in MUAC and a significant predictor of LBW. The sensitivity, specificity, positive predictive value, and negative predictive value for an MUAC of 9.5 cm were 57.5%, 98.8%, 91.6%, and 90.9%, respectively. The correlation coefficient between MUAC and birth weight was 88% and significant and positive (p = 0.0001). There was an 82.4% difference in LBWs with an MUAC less than 9.5 cm compared with those with an MUAC equal to or greater than 9.5 cm (p = 0.0001). Newborns with an MUAC less than 9.5 cm were 10 times more likely to weigh less than 2500 g than those with an MUAC equal to or greater than 9.5 cm (p = 0.0001). Significant maternal risk factors related to LBW were maternal weight less than 43.5 kg (odds ratio [OR] = 2.9), age of 14-19 years (OR = 1.5), height less than 150 cm (OR = 1.3), positive malaria parasitemia (OR = 1.3), and previous history of LBW (OR = 1.5). These findings suggest that, under conditions where conventional scales are not available (e.g., at the primary health care level), an MUAC of 9.5 cm could be used to screen newborns for LBW.
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