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Publication Date: 2009-01-01
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Benjumea Rincón MV, Bacallao Gallestey J, Jiménez R. Low weight and underweight prediction at birth by means of maternal anthropometry. Hacia Promoc. Salud [Internet]. 2009 Jan. 1 [cited 2024 Nov. 24];14(1):35-53. Available from: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2047
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Abstract
Objective: the evaluation of the prognostic ability of an algorithm to predict low weight and underweight at birth based on maternal anthropometry. Materials and methods: the sample was taken from a longitudinal study in 175 pregnant Cuban participants in a program of nutritional surveillance in a health area in Havana, Cuba. The dependent variable was birth weight and maternal independent variables were: gradients of arm circumference, calf, thigh and chest, skin-fold fat and weight of the triceps, subscapularis muscle, suprailiac and calf. Two classification trees were adjusted by means of the CART algorithm, taking as the dependent variable the birth weight recoded as low weight or underweight. Results: the significant predictors for low weight were: the gradients of the arm circumference and calf between the 2nd and 3rd trimesters, and maternal weight between the 1st and 2nd trimesters. The predictors of underweight were gradients of maternal weight between the 1st and 2nd trimesters, and arm circumference between the 2nd and 3rd trimesters. Conclusions: the relative simplicity of the classification trees as a prediction tool, and the low cost of measurement of the identified variables in the model provide a valuable resource to implement nutritional monitoring in pregnant women.
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References
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Kramer MS, Seguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000;14(3):194-210.
Kramer MS. Socioeconomic determinants of intrauterine growth retardation. Eur J Clin Nutr 1998;52 Suppl 1:S29-32.
Vélez M, Barros F, Echavarría L, Hormaza M. Prevalencia de bajo peso al nacer y factores maternos asociados: Unidad de atención y protección materno infantil de la Clínica Universitaria Bolivariana, Medellín, Colombia. Rev Colombiana de Ginecología y Obstetricia 2006;57(4):264-70.
Neufeld L, Pelletier DL, Haas JD. The timing of maternal weight gain during pregnancy and fetal growth. Am J Human Biol 1999;11(5):627-637.
Ruel M. The natural history of growth failure: Importance of intrauterine and postnatal periods. In: Martorell R HF, editor. Nutrition and growth. Nestlé Nutrition Workshop Series, Pediatric Program. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 123-58.
Ruel M, Neufeld L, Habicht J, Martorell R. Stunting at birth: a simple indicator that predicts both risk and benefit among stunted populations. FASEB J 1996;10:A289.
Neufeld L, Haas J, Grajeda R, Martorell R. Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. Am J Clin Nutr 2004;79:646-52.
Banco Internacional de Reconstrucción y Fomento. Banco Mundial. Revalorización del papel fundamental de la nutrición para el desarrollo. Estrategia para una intervención en gran escala Panorama General. 2006. In: Banco Internacional de Reconstrucción y Fomento. Banco Mundial; 2006.
Klebanoff MA, Secher NJ, Mednick BR, Schulsinger C. Maternal size at birth and the development of hypertension during pregnancy: a test of the Barker hypothesis. Arch Intern Med 1999;159(14):1607-12.
Voigt M, Olbertz D, Fusch C, Krafczyk D, Briese V, Schneider KT. The Influence of Previous Pregnancy Terminations, Miscarriages and Still-Births on the Incidence of Babies with Low Birth Weight and Premature Births as well as a Somatic Classification of New Borns. Z Geburtshilfe Neonatol 2008;212(1):5-12.
PROFAMILIA. Salud sexual y reproductiva. Resultados. Encuesta Nacional de Demografía y Salud 2005. Encuesta. Bogotá: PROFAMILIA; 2005.
Ortiz E. Estrategias para la prevención del bajo peso al nacer en una población de alto riesgo, según la medicina basada en la evidencia. Colombia Med 2001;32:159-162.
Kramer MS, Barros FC, Demissie K, Liu S, Kiely J, Joseph KS. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatr Perinat Epidemiol 2005;19(6):445-51.
González-Pérez G, Vega-López M. Factores de Riesgo del Peso al Nacer Desfavorable en Áreas Periféricas de Guadalajara, México. Cad. Saúde Públ. 1995;11(2):271-80.
Prendes-Labrada M, Jiménez G, González-Pérez R, Guibert W. Estado nutricional materno y peso al nacer. Rev Cubana Med Gen Integr 2001;17(1):35-42.
Mardones-Restat F. Beneficios de la seguridad social en el cuidado de la nutrición y la salud de la madre y el niño en Chile. Revista Chilena de Nutrición 1984;12:23-27.
Rosero-Bixby L. Determinantes del descenso de la mortalidad infantil en Costa Rica. Boletín de la Oficina Sanitaria Panamericana 1985;99:510-527.
McCormick M. The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 1985;312:82-90.
Alonso V, Fuster V, Luna F. La Evolución del Peso al Nacer en España (1981-2002) y su relación con las Características de la Reproducción. Antropo 2005;10:51-60.
Leung TY, Sahota DS, Chan LW, Law LW, Fung TY, Leung TN et al. Prediction of birth weight by fetal crown-rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester. Ultrasound Obstet Gynecol 2008;31(1):10-4.
Cox S. Weight gain during pregnancy. J Midwifery Womens Health 2003;48(3):229-30.
Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr 2000;71(5 Suppl):1233S-41S.
Brennand EA, Dannenbaum D, Willows ND. Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain. J Obstet Gynaecol Can 2005;27(10):936-44.
Macea JR, Kronfly FS, Meserani Ade L. Weight of the newborn in relation to maternal weight gains in 513 normal pregnancies: analysis of different stages of the maternal weight at the onset of pregnancy. Rev Assoc Med Bras 1996;42(3):155-61.
Kusumayati A, Gross R. Ecological and geographic characteristics predict nutritional status of communities: rapid assessment for poor villages. Health Policy Plan 1998;13(4):408-16.
Delpeuch F, Traissac P, Martin-Prevel Y, Massamba JP, Maire B. Economic crisis and malnutrition: socioeconomic determinants of anthropometric status of preschool children and their mothers in an African urban area. Public Health Nutr 2000;3(1):39-47.
Derbyshire E. Low maternal weight: effects on maternal and infant health during pregnancy. Nurs Stand 2007;22(3):43-6.
Bershtein LM, Levinson LL, Strukova GN. [Changes in skinfold thickness in the course of normal pregnancy and their relation to fetal weight]. Akush Ginekol (Mosk) 1980(8):44-6.
Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN, Jr. Maternal body fat and water during pregnancy: do they raise infant birth weight? Am J Obstet Gynecol 1999;180(1 Pt 1):235-40.
Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN, Jr. Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet Gynecol 1997;90(4 Pt 1):483-8.
Benjumea MV. Exactitud diagnóstica de cinco referencias gestacionales para predecir el peso insuficiente al nacer. Biomédica 2007;27(1):42-55.
Hastie T, Tibshirani R. Hastie T, Tibshirani R. Generalized additive models. London: Chapman & Hall. 1990. Disponible en: http://support.sas.com/rnd/app/da/new/dagam.html. Acceso el 10 de agosto de 2007.
Strauss RS, Dietz WH. Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation. J Nutr 1999;129(5):988-93.
Brown JE, Murtaugh MA, Jacobs DR, Jr., Margellos HC. Variation in newborn size according to pregnancy weight change by trimester. Am J Clin Nutr 2002;76(1):205-9.
Paxton A, Lederman SA, Heymsfield SB, Wang J, Thornton JC, Pierson RN, Jr. Anthropometric equations for studying body fat in pregnant women. Am J Clin Nutr 1998;67(1):104-10.
Bronstein MN MR, King JC. Unexpected relationship between fat mass and basal metabolic rate in pregnant women. Br J Nutr 1996;75:659-668.
Grandi CA. Relación entre la antropometría materna y la ganancia de peso gestacional con el peso de nacimiento, y riesgos de peso bajo al nacer pequeño para la edad gestacional y prematurez en una población urbana de Buenos Aires. Arch Latinoam Nutr 2003;53(4):369-75.
Zhang H, Singer B. Recursive Partitioning in the Health Sciences. New York: Springer-Verlag; 1999.
Camp NJ, Slattery ML. Classification tree analysis: a statistical tool to investigate risk factor interactions with an example for colon cancer (United States). Cancer Causes Control 2002;13(9):813-23.
Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W. Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 2003;26(3):172-81.
Ambalavanan N, Baibergenova A, Carlo WA, Saigal S, Schmidt B, Thorpe KE. Early prediction of poor outcome in extremely low birth weight infants by classification tree analysis. J Pediatr 2006;148(4):438-444.
Caetano MR, Couto E, Passini R, Jr., Simoni RZ, Barini R. Gestational prognostic factors in women with recurrent spontaneous abortion. Sao Paulo Med J 2006;124(4):181-5.
Razavi AR, Nystrom M, Stachowicz MS, Gill H, Ahlfeldt H, Shahsavar N. An approach for generating fuzzy rules from decision trees. Stud Health Technol Inform 2006;124:581-6.
Bacallao J, Parapar JM, Roque M, Bacallao J. Árboles de regresión y otras opciones metodológicas aplicadas a la predicción del rendimiento académico. Ed Médica Sup. 2004;18(3):1-9.
Breiman L, Friedman JH, Losen RA, Stone CJ. Classification and regresion trees. Monterrey CA: Wadsworth & Brooks/Cole Advanced Books and Software; 1984.
Lim TS, Loh WH, Shih YS. An empirical comparison of decision trees and other classification methods. (Technical Report 979. Departments of Statistics). Madison: University of Wisconsin; 1997.
Loh WY, Shih YS. Split selection methods for classification trees. Statistica Sinica 1997;7:815-840.
Ciampi A, Couturier A, Li S. Prediction trees with soft nodes for binary outcomes. Stat Med 2002;21(8):1145-65.
Grobman WA, Stamilio DM. Methods of clinical prediction. Am J Obstet Gynecol 2006;194(3):888-94.
Elson J, Tailor A, Banerjee S, Salim R, Hillaby K, Jurkovic D. Expectant management of tubal ectopic pregnancy: prediction of successful outcome using decision tree analysis. Ultrasound Obstet Gynecol 2004;23(6):552-6.
Das JC, Khanam ST. Correlation of anthropometric measurements of mothers and their newborns. Bangladesh Med Res Counc Bull 1997;23(1):10-5.
Walker SP, Ewan-Whyte C, Chang SM, Powell CA, Fletcher H, McDonald D et al. Factors associated with size and proportionality at birth in term Jamaican infants. J Health Popul Nutr 2003;21(2):117-26.
Urrutia M, Mardones F, Salazar G. Asociación entre la composición corporal de la embarazada y la composición corporal del recién nacido. Rev. Chil. Pediatr 2001;72(3):212-218.
Viegas OA, Cole TJ, Wharton BA. Impaired fat deposition in pregnancy: an indicator for nutritional intervention. Am J Clin Nutr 1987;45(1):23-8.
Benjumea MV. Antropometría materna como predictora del peso al nacer [Tesis Doctoral]. La Habana: Instituto Superior de Ciencias Médicas; Cuba 2008. p.149.
Santana S, Espinosa A. Composición corporal. Acta Médica 2003;11(1):26-37.
Benjumea MV. Bioética en la vigilancia epidemiológica de la gestante colombiana. Revista Perspectivas en Nutrición Humana 2003;9:46-71.
Kramer MS, Seguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000;14(3):194-210.
Kramer MS. Socioeconomic determinants of intrauterine growth retardation. Eur J Clin Nutr 1998;52 Suppl 1:S29-32.
Vélez M, Barros F, Echavarría L, Hormaza M. Prevalencia de bajo peso al nacer y factores maternos asociados: Unidad de atención y protección materno infantil de la Clínica Universitaria Bolivariana, Medellín, Colombia. Rev Colombiana de Ginecología y Obstetricia 2006;57(4):264-70.
Neufeld L, Pelletier DL, Haas JD. The timing of maternal weight gain during pregnancy and fetal growth. Am J Human Biol 1999;11(5):627-637.
Ruel M. The natural history of growth failure: Importance of intrauterine and postnatal periods. In: Martorell R HF, editor. Nutrition and growth. Nestlé Nutrition Workshop Series, Pediatric Program. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 123-58.
Ruel M, Neufeld L, Habicht J, Martorell R. Stunting at birth: a simple indicator that predicts both risk and benefit among stunted populations. FASEB J 1996;10:A289.
Neufeld L, Haas J, Grajeda R, Martorell R. Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. Am J Clin Nutr 2004;79:646-52.
Banco Internacional de Reconstrucción y Fomento. Banco Mundial. Revalorización del papel fundamental de la nutrición para el desarrollo. Estrategia para una intervención en gran escala Panorama General. 2006. In: Banco Internacional de Reconstrucción y Fomento. Banco Mundial; 2006.
Klebanoff MA, Secher NJ, Mednick BR, Schulsinger C. Maternal size at birth and the development of hypertension during pregnancy: a test of the Barker hypothesis. Arch Intern Med 1999;159(14):1607-12.
Voigt M, Olbertz D, Fusch C, Krafczyk D, Briese V, Schneider KT. The Influence of Previous Pregnancy Terminations, Miscarriages and Still-Births on the Incidence of Babies with Low Birth Weight and Premature Births as well as a Somatic Classification of New Borns. Z Geburtshilfe Neonatol 2008;212(1):5-12.
PROFAMILIA. Salud sexual y reproductiva. Resultados. Encuesta Nacional de Demografía y Salud 2005. Encuesta. Bogotá: PROFAMILIA; 2005.
Ortiz E. Estrategias para la prevención del bajo peso al nacer en una población de alto riesgo, según la medicina basada en la evidencia. Colombia Med 2001;32:159-162.
Kramer MS, Barros FC, Demissie K, Liu S, Kiely J, Joseph KS. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas. Paediatr Perinat Epidemiol 2005;19(6):445-51.
González-Pérez G, Vega-López M. Factores de Riesgo del Peso al Nacer Desfavorable en Áreas Periféricas de Guadalajara, México. Cad. Saúde Públ. 1995;11(2):271-80.
Prendes-Labrada M, Jiménez G, González-Pérez R, Guibert W. Estado nutricional materno y peso al nacer. Rev Cubana Med Gen Integr 2001;17(1):35-42.
Mardones-Restat F. Beneficios de la seguridad social en el cuidado de la nutrición y la salud de la madre y el niño en Chile. Revista Chilena de Nutrición 1984;12:23-27.
Rosero-Bixby L. Determinantes del descenso de la mortalidad infantil en Costa Rica. Boletín de la Oficina Sanitaria Panamericana 1985;99:510-527.
McCormick M. The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 1985;312:82-90.
Alonso V, Fuster V, Luna F. La Evolución del Peso al Nacer en España (1981-2002) y su relación con las Características de la Reproducción. Antropo 2005;10:51-60.
Leung TY, Sahota DS, Chan LW, Law LW, Fung TY, Leung TN et al. Prediction of birth weight by fetal crown-rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester. Ultrasound Obstet Gynecol 2008;31(1):10-4.
Cox S. Weight gain during pregnancy. J Midwifery Womens Health 2003;48(3):229-30.
Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr 2000;71(5 Suppl):1233S-41S.
Brennand EA, Dannenbaum D, Willows ND. Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain. J Obstet Gynaecol Can 2005;27(10):936-44.
Macea JR, Kronfly FS, Meserani Ade L. Weight of the newborn in relation to maternal weight gains in 513 normal pregnancies: analysis of different stages of the maternal weight at the onset of pregnancy. Rev Assoc Med Bras 1996;42(3):155-61.
Kusumayati A, Gross R. Ecological and geographic characteristics predict nutritional status of communities: rapid assessment for poor villages. Health Policy Plan 1998;13(4):408-16.
Delpeuch F, Traissac P, Martin-Prevel Y, Massamba JP, Maire B. Economic crisis and malnutrition: socioeconomic determinants of anthropometric status of preschool children and their mothers in an African urban area. Public Health Nutr 2000;3(1):39-47.
Derbyshire E. Low maternal weight: effects on maternal and infant health during pregnancy. Nurs Stand 2007;22(3):43-6.
Bershtein LM, Levinson LL, Strukova GN. [Changes in skinfold thickness in the course of normal pregnancy and their relation to fetal weight]. Akush Ginekol (Mosk) 1980(8):44-6.
Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN, Jr. Maternal body fat and water during pregnancy: do they raise infant birth weight? Am J Obstet Gynecol 1999;180(1 Pt 1):235-40.
Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN, Jr. Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet Gynecol 1997;90(4 Pt 1):483-8.
Benjumea MV. Exactitud diagnóstica de cinco referencias gestacionales para predecir el peso insuficiente al nacer. Biomédica 2007;27(1):42-55.
Hastie T, Tibshirani R. Hastie T, Tibshirani R. Generalized additive models. London: Chapman & Hall. 1990. Disponible en: http://support.sas.com/rnd/app/da/new/dagam.html. Acceso el 10 de agosto de 2007.
Strauss RS, Dietz WH. Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation. J Nutr 1999;129(5):988-93.
Brown JE, Murtaugh MA, Jacobs DR, Jr., Margellos HC. Variation in newborn size according to pregnancy weight change by trimester. Am J Clin Nutr 2002;76(1):205-9.
Paxton A, Lederman SA, Heymsfield SB, Wang J, Thornton JC, Pierson RN, Jr. Anthropometric equations for studying body fat in pregnant women. Am J Clin Nutr 1998;67(1):104-10.
Bronstein MN MR, King JC. Unexpected relationship between fat mass and basal metabolic rate in pregnant women. Br J Nutr 1996;75:659-668.
Grandi CA. Relación entre la antropometría materna y la ganancia de peso gestacional con el peso de nacimiento, y riesgos de peso bajo al nacer pequeño para la edad gestacional y prematurez en una población urbana de Buenos Aires. Arch Latinoam Nutr 2003;53(4):369-75.
Zhang H, Singer B. Recursive Partitioning in the Health Sciences. New York: Springer-Verlag; 1999.
Camp NJ, Slattery ML. Classification tree analysis: a statistical tool to investigate risk factor interactions with an example for colon cancer (United States). Cancer Causes Control 2002;13(9):813-23.
Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W. Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 2003;26(3):172-81.
Ambalavanan N, Baibergenova A, Carlo WA, Saigal S, Schmidt B, Thorpe KE. Early prediction of poor outcome in extremely low birth weight infants by classification tree analysis. J Pediatr 2006;148(4):438-444.
Caetano MR, Couto E, Passini R, Jr., Simoni RZ, Barini R. Gestational prognostic factors in women with recurrent spontaneous abortion. Sao Paulo Med J 2006;124(4):181-5.
Razavi AR, Nystrom M, Stachowicz MS, Gill H, Ahlfeldt H, Shahsavar N. An approach for generating fuzzy rules from decision trees. Stud Health Technol Inform 2006;124:581-6.
Bacallao J, Parapar JM, Roque M, Bacallao J. Árboles de regresión y otras opciones metodológicas aplicadas a la predicción del rendimiento académico. Ed Médica Sup. 2004;18(3):1-9.
Breiman L, Friedman JH, Losen RA, Stone CJ. Classification and regresion trees. Monterrey CA: Wadsworth & Brooks/Cole Advanced Books and Software; 1984.
Lim TS, Loh WH, Shih YS. An empirical comparison of decision trees and other classification methods. (Technical Report 979. Departments of Statistics). Madison: University of Wisconsin; 1997.
Loh WY, Shih YS. Split selection methods for classification trees. Statistica Sinica 1997;7:815-840.
Ciampi A, Couturier A, Li S. Prediction trees with soft nodes for binary outcomes. Stat Med 2002;21(8):1145-65.
Grobman WA, Stamilio DM. Methods of clinical prediction. Am J Obstet Gynecol 2006;194(3):888-94.
Elson J, Tailor A, Banerjee S, Salim R, Hillaby K, Jurkovic D. Expectant management of tubal ectopic pregnancy: prediction of successful outcome using decision tree analysis. Ultrasound Obstet Gynecol 2004;23(6):552-6.
Das JC, Khanam ST. Correlation of anthropometric measurements of mothers and their newborns. Bangladesh Med Res Counc Bull 1997;23(1):10-5.
Walker SP, Ewan-Whyte C, Chang SM, Powell CA, Fletcher H, McDonald D et al. Factors associated with size and proportionality at birth in term Jamaican infants. J Health Popul Nutr 2003;21(2):117-26.
Urrutia M, Mardones F, Salazar G. Asociación entre la composición corporal de la embarazada y la composición corporal del recién nacido. Rev. Chil. Pediatr 2001;72(3):212-218.
Viegas OA, Cole TJ, Wharton BA. Impaired fat deposition in pregnancy: an indicator for nutritional intervention. Am J Clin Nutr 1987;45(1):23-8.
Benjumea MV. Antropometría materna como predictora del peso al nacer [Tesis Doctoral]. La Habana: Instituto Superior de Ciencias Médicas; Cuba 2008. p.149.
Santana S, Espinosa A. Composición corporal. Acta Médica 2003;11(1):26-37.
Benjumea MV. Bioética en la vigilancia epidemiológica de la gestante colombiana. Revista Perspectivas en Nutrición Humana 2003;9:46-71.
