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Midupper Arm Circumference (MUAC) Changes in Late Pregnancy Predict Fetal Growth in Twins

Published online by Cambridge University Press:  21 February 2012

Mary L. Hediger ,
Barbara Luke ,
Cosmas van de Ven  and
Clark Nugent
Mary L. Hediger*
Affiliation:
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Maryland, United States of America. [email protected]
Barbara Luke
Affiliation:
University of Miami School of Nursing and Health Studies and Department of Obstetrics and Gynecology, School of Medicine, Florida, United States of America.
Cosmas van de Ven
Affiliation:
Department of Obstetrics and Gynecology, University of Michigan Medical School, Michigan, United States of America.
Clark Nugent
Affiliation:
Department of Obstetrics and Gynecology, University of Michigan Medical School, Michigan, United States of America.
*
*Address for correspondence: Mary L. Hediger, PhD, Epidemiology Branch, DESPR, Building 6100, Room 7B03, MSC 7510, 9000 Rockville Pike, Bethesda, Maryland 20892-7510, USA.

Abstract

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The objective of the study was to test the hypothesis that changes in arm anthropometry can be used to determine the risk of faltering growth in twin gestations. Serial data on midupper arm circumference (MUAC) and maternal weight gain were collected from a sample of 156 mothers. Changes in MUAC were monitored from 20 to 34 weeks. Women with a large loss of MUAC (greater than 1.5 cm), particularly when it occurred within two to four weeks of delivery, were significantly heavier, had higher pregravid Body Mass Indexes (BMIs), but gained less weight than mothers with no change in MUAC. In analysis of covariance models adjusting for length of gestation, black ethnicity, males per twin pair, monochorionicity, and baseline MUAC at 20 weeks, a large loss of MUAC was associated with significantly lower birthweight (2263 g vs. 2499 g) and birthweight z-score (–0.92 SDU vs. –0.39 SDU). Changes in MUAC from 20 to 34 weeks, and especially near delivery, are significantly associated with fetal growth in twin pregnancies. A positive change may indicate that the mother has adequate dietary intake or nutrient stores to continue to accrue lean body mass and support fetal growth, while a loss of MUAC indicates that dietary intake or nutrient stores may be inadequate. This simple, relatively precise, measure of change in maternal body composition during pregnancy may be useful in identifying twin pregnancies at risk for faltering intrauterine growth, particularly among overweight or obese women.

Type
Articles
Information
Twin Research and Human Genetics , Volume 8 , Issue 3 , 01 June 2005 , pp. 267 - 270
Copyright
Copyright © Cambridge University Press 2005