Resumo

ADRIANA LIZBETT, Espinoza Almazán; LARA, Maria Eugenia  e  NAVIA BUENO, Maria del Pilar. VALIDACIÓN DEL ÍNDICE DE MASA CORPORAL EN EMBARAZADAS CON RELACIÓN AL NOMOGRAMA DE ROSSO Y MARDONES LA PAZ - BOLIVIA. Cuad. - Hosp. Clín. [online]. 2006, vol.51, n.2, pp. 25-33. ISSN 1652-6776.

RESEARCH QUESTION What is the validity of the Body Mass Index in pregnant women in relation to the Normogram of Rosso and Mardones in the Hospitals "Materno Infantil" " de la Mujer", and "Boliviano Holandés" in La Paz, from January to February 2002 ? GENERAL OBJECTIVE To determine sensibility, specificity, positive and negative predictive values, in addition to likelihood ratio and Body Mass Index in pregnant women in relation to the Normogram of Pedro Rosso and Mardones in the Hospitals "Materno Infantil", "de la Mujer", and Boliviano Holandés" from January to February 2002. RESEARCH DESIGN Diagnostic test SITE "Hospital Materno Infantil", "Hospital de la Mujer", "Hospital Boliviano Holandés" in La Paz. SAMPLE The sample consisted of 479 pregnant women, from the 10th week of gestation to 40 weeks of gestational age who came for routine prenatal control to the above mentioned hospitals. METHODS We assessed the nutritional status of the pregnant woman using the Body Mass Index (the test to be validated), and the Normogram of Rosso and Mardones (Gold Standard). For the calculation of sensibility, specificity, negative and positive predictive values, we used the statistic package EPIDATA, and for the statistic calculus the statistic package STATA 6.0. For the descriptive analysis we used measures of central tendency and of dispersion like Mean, Standard Deviation, verifying by means of calculating the Confidence Interval 95%, percentages and frequency for the qualitative values. In order to establish the relationship between both tests we used the tests of Correlation and Chi2 . RESULTS The present study was carried out in 479 pregnant women who came to the routine prenatal control in January and February 2002 in the Hospitals "Materno Infantil", "Boliviano Holandés", and "Hospital de la Mujer". The nutritional diagnose of the pregnant women showed that the majority belonged in the normal range, in both tests. Maternal malnutrition resulted to be greater in the Rosso diagnostic test. The distribution of the Body Mass Index is normal according to the gráfico de cajas and according to the variability of the dispersion of the Standard Deviation which is greater with relation to Rosso. The results of the correlation between the test of the BMI and the Normogram of Rosso and Mardones show a remarkable agreement with a very good positive correlation r=0.97, and very significant (Spearman p <0.000). These values confirm the coherence of the Gold Standard, the power of the measurement of the BMI, its internal validity, and the capacity of this test to measure what it intends to measure. The values of the diagnostic test for the BMI are: 81% for Sensibility, 89% for Specificity, 93% for the positive Predictive Value, 74% for the negative Predictive Value, 7.53 for Likelihood Ratio + 0.20 for negative Likelihood Ratio. CONCLUSIONS The test of the BMI is valid in relation to the Normogram of Rosso and Mardones for the evaluation of pregnant women at a national level, taking into consideration : a) the high values of specificity, sensibility which permit to precisely identify pregnant women in adequate nutritional status and in inadequate nutritional status (low body weight, overweight or obesity), b) the high positive and negative predictive values which confirm sensibility and specificity, and c) the positive correlation between both tests and the highly significant association (p=0.000).

Palavras-chave : Body Mass Index (BMI); Normogram of Rosso and Mardones; Sensibility; Specificity.