Academic journal articles (including pre-print submissions)

Mid-arm circumference cut-offs for identifying underweight and severe underweight among infants less than 6 months: A hospital based cross sectional study

Geographies India

Rajesh Sinha,

Updated 24 Jul 2023
Title and authors of the publication


revalence of undernutrition among infants <6 months are very high in India. WAZ is the most sensitive predictor of mortality among infants <6 months as compared to other anthropometric parameters. However, taking weight and calculating z-score in the community setting have many challenges. Taking mid upper arm circumference (MUAC) is more feasible in a field setting.

Methodology: A cross-sectional study was conducted with 419 infants <6 months in a tertiary care hospital in India to identify appropriate MUAC cutoffs for identifying underweight (WAZ<-2) and severe underweight (WAZ<-3) among infants <6 months by calculating sensitivities, specificities and Youden indices. Cohen kappa coefficients were calculated to assess agreements between MUAC and WAZ cutoffs.

Results: The MUAC cut-offs for underweight and severe underweight were calculated as 11cm (Youden Index: 0.503; sensitivity: 83.4%; specificity: 66.9%) and 10.9cm (Youden Index: 0.504; sensitivity: 76.3%; specificity: 74.1%), respectively. Kappa coefficients to diagnose underweight with MUAC<=11cm was highest at 0.48.

Conclusions: The MUAC cut-off of 11cm could reliably be used to screen infants <6 months with underweight and severe underweight for providing appropriate care in the Indian settings. 

Rajesh Sinha,

Updated 24 Jul 2023
View all updates