Assessing the role of mid upper arm circumference in identification of low birthweight and wasting in early infancy in India

Abstract

Aim We conducted this study to examine the mid upper‐arm circumference (MUAC) of full‐term infants from birth to 6 months; construct gender‐specific MUAC graphs; and assess the role of MUAC as a surrogate marker for low birthweight and wasting in infants younger than 6 months. Methods This is a prospective longitudinal study of 268 (133 female and 135 male) new‐borns in a tertiary care centre in Navi Mumbai, India. We measured weight, length, head circumference and MUAC. We drew the MUAC curves for the first 6 months using the mean MUAC and standard deviation (SD) values and assessed the diagnostic test properties of MUAC at birth as a marker of low birthweight. Results The mean (SD) birthweight of the male and female new‐borns was 2756.2 g (368.1) and 2803.8 g (326.2), respectively (P = 0.25). The mean (SD) MUAC at birth was 8.7 (0.3) cm in males and 8.8 (0.2) cm in females, respectively (P = 0.14). The plotted mean MUAC curve in infants who were classified with wasting was between the −1SD and −2SD in both genders. The sensitivity and NPV for detecting low birthweight were 100% at cut‐off of 8.6 cm in females and 8.7 cm in males, respectively (area under the curve: 0.92 (females) and 0.96 (males)). Conclusion MUAC may be a good proxy for low birthweight at birth and the curves from our study show that it may also help in the diagnosis of wasting in infants below 6 months of age in the community, particularly in resource‐constrained settings.