Maternal mid-upper arm circumference as a predictor of low birth weight outcome among newborn deliveries of adolescents in a Tertiary Level Hospital

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.

Factors associated with obstetric and perinatal outcomes among pregnant teen/adolescent Filipino 13–19 years old in a tertiary hospital

Background@#The 2013 National Demographic and Health Survey (NDHS) showed that 1 in 10 young Filipino women aged 15–19 years are childbearing. Yet, teenage pregnancy is known to be associated with complications in the mother and the child. @*Objective@#This study aimed to describe the sociodemographic characteristics and obstetric and perinatal outcomes of teenage pregnancy among Filipino women aged 13–19 years at the Philippine General Hospital. @*Methods@#This is a retrospective study consisting of reviewing the hospital records of teenage mothers from years 2014–2016. Descriptive statistics were used to analyze the gathered data. @*Results@#Almost 50% of the cases of adolescent pregnancy yielded obstetric and perinatal complications. The odds of having abnormal obstetric outcome among mothers with obstetric score of g1 is 7.8 times (95% CI: 2.0 to 30.7) higher as compared to other gravida scores and the odds of having at least one perinatal disorder decreases by 19% (95% CI: 6% to 30%) as the mothers regularly visit an obstetric clinic. This study also showed that among the pregnant adolescents, most of their partners were of legal age. Thirty-nine (23.9%) of them were seen by the Adolescent Service while 31(19%) were seen by the Child Protection Unit (CPU). @*Conclusion@#With the noted obstetric and perinatal outcomes, teenage pregnancy is an important issue that needs to be dealt with. To ensure good outcomes, provision of health care services designed particularly to cater to the needs of adolescent mothers should be properly and timely implemented. A referral to the Adolescent Service and CPU will greatly improve policies pertaining to provision of holistic care and protection services to teenage mothers.