Ververs Mija-Tesse, Antierens Annick, Sackl Anita, Staderini Nelly, Captier Valerie
Medical Department, Médecins Sans Frontières, Geneva, Switzerland.
PLoS Curr. 2013 Jun 7;5:ecurrents.dis.54a8b618c1bc031ea140e3f2934599c8. doi: 10.1371/currents.dis.54a8b618c1bc031ea140e3f2934599c8.
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.
目前，对于如何识别严重营养不良的孕妇以及何时让她们加入营养项目，尚无共识。瑞士无国界医生组织进行了一项文献综述，目的是确定与不良出生结局（如低出生体重、早产和宫内生长迟缓）相关的急性营养不良人体测量指标的值。在PUBMED上进行了文献检索，涵盖1995年1月1日至2012年9月12日，关键词为孕产妇人体测量学和妊娠。该综述聚焦于人道主义背景。由于上臂中部周长（MUAC）与低出生体重的关联相对较强、临界值范围窄、测量简单（在人道主义环境中很重要）且不需要事先了解孕周，因此被确定为首选指标。确定大多数不良反应出现时的MUAC值分别为<22 cm和<23 cm。建议采用<23 cm的保守临界值，以便将非洲和亚洲地区大多数婴儿有低出生体重风险的孕妇纳入其中。
