Background: Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition. Objectives: The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital. Methods. A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination. Results: Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve. Conclusion This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.
Pregnancy in Adolescence

Objectives. 1) To determine the nutritional status of pregnant adolescents aged 14 to 19 years seen at the Philippine General Hospital Teen Mom Clinic from February to July 2014; 2) To describe the demographic characteristics, pregnancy history, and lifestyle and health habits of adolescent mothers; 3) To describe the adequacy of the daily intake of nutrients (caloric energy, carbohydrates, protein, fats, folate, calcium, and iron) of adolescent mothers; and 4) To determine the association of specific demographic characteristics with body mass index categories.

Methods. This was a prospective cross-sectional study. Included were the pregnant adolescents aged 14 to 19 years of age, referred to the Teen Mom Clinic, who planned to deliver at the Philippine General Hospital. Informed consent and assent forms were signed, and the principal investigator interviewed the subjects for demographic and clinical history at the time of enrolment. The adolescents were taught and instructed to fill up the food diary (2 weekdays and 1 weekend) and the food frequency (once) forms. These were submitted on their next visit and given to a licensed nutritionist for analysis. The nutritional status was assessed by gathering the weight and height of the patients in order to compute for the body mass index at the time of enrolment in the study.

Results. The percentage distribution of nutritional status of pregnant adolescents consisted of the following: 65% normal; 28% underweight; 3.5% overweight; 3.5% obese. The 60 pregnant adolescents had a mean age of 16.9 years (SD 1.2). Their partners had a mean age of 20.3 years [SD 3.8]. On the average, they had a total of five pre-natal checkups. Majority of the respondents (85%) still depended primarily on their parents for financial support. Around 93% of the pregnancies were unplanned. Their median percent adequacy for daily calories was 72%, carbohydrates 69%, proteins 73%, and fats 86%. For the micronutrients, the median percent adequacies for folate, calcium, and iron, based on the needs of pregnant women, were 18%, 63%, and 29%, respectively. If amounts were compared to the requirements by age, the median adequacies of intake were 27%, 50%, and 41%, respectively. The nutritional status was not found dependent on the age, educational attainment, number of siblings, and the monthly family income of the respondents.

Conclusion. Only 65% of the pregnant adolescents had normal nutritional status. There was still an elevated level of malnutrition among pregnant adolescents as shown in this study: 28% were underweight, 3.3% were overweight, and another 3.3% were obese.

Human ; Female ; Adolescent (a Person 13-18 Years Of Age)

BACKGROUND

Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.

OBJECTIVES

The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital.

METHODS

A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.

RESULTS

Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.

CONCLUSION

This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.

Human ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Pregnancy In Adolescence ; Infant, Low Birth Weight ; Adolescent Mothers