Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy

ABSTRACT Chile, and several Latin American countries, use the Atalah standard to assess nutritional status during pregnancy. However, this standard (underweight: pre-pregnancy body mass index (BMI)<20 kg/m2 and normal weight: pre-pregnancy BMI= 20-24.9 kg/m2) differ from those recommended by the...

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Autores principales:	Araya B,Marcela, Kusanovic,Juan Pedro, Corvalán,Camila, Garmendia,María Luisa
Lenguaje:	English
Publicado:	Sociedad Chilena de Nutrición, Bromatología y Toxicología 2021
Materias:	Gestational weight gain IOM Nutritional status assessment Pregnancy Pre-pregnancy underweight
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75182021000500717
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spelling	oai:scielo:S0717-751820210005007172021-10-27Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancyAraya B,MarcelaKusanovic,Juan PedroCorvalán,CamilaGarmendia,María Luisa Gestational weight gain IOM Nutritional status assessment Pregnancy Pre-pregnancy underweight ABSTRACT Chile, and several Latin American countries, use the Atalah standard to assess nutritional status during pregnancy. However, this standard (underweight: pre-pregnancy body mass index (BMI)<20 kg/m2 and normal weight: pre-pregnancy BMI= 20-24.9 kg/m2) differ from those recommended by the US Institute of Medicine (IOM2009) (underweight: BMI<18.5 kg/m2 and normal weight: 18.5-24.9 kg/m2). Using a large population database from a Chilean public hospital, we compared the prevalence of underweight and normal weight at the beginning of pregnancy with Atalah and IOM2009 standards. Additionally, we evaluated the performance of both standards in detecting adverse neonatal outcomes and gestational weight gain. Methods: Data from clinical records of single birth pregnancies (n= 59,476) at the Sótero del Río Hospital, between 2003-2012 were collected. We compared 1. nutritional status, 2. proportion of excessive gestational weight gain, 3. association between nutritional status and neonatal outcomes (large/small for gestational age, low birth weight, preterm birth and macrosomia), using logistic regression models, and 4. Sensitivity, specificity, and predictive values to predict adverse neonatal outcomes per nutritional status. Results: Pre-pregnancy underweight decreased from 8.6% to 2.5% and women with BMI between 18.5-19.9kg/m2, who exceeded the recommended gestational weight gain increased from 32.7% to 49.2% when using IOM2009 instead of Atalah. Both standards showed low sensitivity, but the IOM2009 cut-off points showed better specificity for identifying healthy newborns. Conclusion: The cut-off points recommended by the IOM2009 better identify the prevalence of underweight and normal weight during pregnancy without increasing neonatal risk. This study supports the recent change of the Ministry of Health in adopting the WHO cut-off points during pregnancy.info:eu-repo/semantics/openAccessSociedad Chilena de Nutrición, Bromatología y ToxicologíaRevista chilena de nutrición v.48 n.5 20212021-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75182021000500717en10.4067/S0717-75182021000500717
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Gestational weight gain IOM Nutritional status assessment Pregnancy Pre-pregnancy underweight
spellingShingle	Gestational weight gain IOM Nutritional status assessment Pregnancy Pre-pregnancy underweight Araya B,Marcela Kusanovic,Juan Pedro Corvalán,Camila Garmendia,María Luisa Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
description	ABSTRACT Chile, and several Latin American countries, use the Atalah standard to assess nutritional status during pregnancy. However, this standard (underweight: pre-pregnancy body mass index (BMI)<20 kg/m2 and normal weight: pre-pregnancy BMI= 20-24.9 kg/m2) differ from those recommended by the US Institute of Medicine (IOM2009) (underweight: BMI<18.5 kg/m2 and normal weight: 18.5-24.9 kg/m2). Using a large population database from a Chilean public hospital, we compared the prevalence of underweight and normal weight at the beginning of pregnancy with Atalah and IOM2009 standards. Additionally, we evaluated the performance of both standards in detecting adverse neonatal outcomes and gestational weight gain. Methods: Data from clinical records of single birth pregnancies (n= 59,476) at the Sótero del Río Hospital, between 2003-2012 were collected. We compared 1. nutritional status, 2. proportion of excessive gestational weight gain, 3. association between nutritional status and neonatal outcomes (large/small for gestational age, low birth weight, preterm birth and macrosomia), using logistic regression models, and 4. Sensitivity, specificity, and predictive values to predict adverse neonatal outcomes per nutritional status. Results: Pre-pregnancy underweight decreased from 8.6% to 2.5% and women with BMI between 18.5-19.9kg/m2, who exceeded the recommended gestational weight gain increased from 32.7% to 49.2% when using IOM2009 instead of Atalah. Both standards showed low sensitivity, but the IOM2009 cut-off points showed better specificity for identifying healthy newborns. Conclusion: The cut-off points recommended by the IOM2009 better identify the prevalence of underweight and normal weight during pregnancy without increasing neonatal risk. This study supports the recent change of the Ministry of Health in adopting the WHO cut-off points during pregnancy.
author	Araya B,Marcela Kusanovic,Juan Pedro Corvalán,Camila Garmendia,María Luisa
author_facet	Araya B,Marcela Kusanovic,Juan Pedro Corvalán,Camila Garmendia,María Luisa
author_sort	Araya B,Marcela
title	Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
title_short	Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
title_full	Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
title_fullStr	Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
title_full_unstemmed	Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy
title_sort	impact of the change of the atalah standard cut-off point to classify underweight nutritional status during pregnancy
publisher	Sociedad Chilena de Nutrición, Bromatología y Toxicología
publishDate	2021
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75182021000500717
work_keys_str_mv	AT arayabmarcela impactofthechangeoftheatalahstandardcutoffpointtoclassifyunderweightnutritionalstatusduringpregnancy AT kusanovicjuanpedro impactofthechangeoftheatalahstandardcutoffpointtoclassifyunderweightnutritionalstatusduringpregnancy AT corvalancamila impactofthechangeoftheatalahstandardcutoffpointtoclassifyunderweightnutritionalstatusduringpregnancy AT garmendiamarialuisa impactofthechangeoftheatalahstandardcutoffpointtoclassifyunderweightnutritionalstatusduringpregnancy
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Impact of the change of the Atalah standard cut-off point to classify underweight nutritional status during pregnancy

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