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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy
PLoS ONE, Volume 7, No. 8, Article e41934, Year 2012
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Description
Objective: Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Design: Prospective cohort. Methods: HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Results: Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%. Conclusions: In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Trial Registration: Clinicaltrials.gov NCT00993031. © 2012 Young et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s001.tiff
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s002.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s003.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s004.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s005.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s006.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s007.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s008.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3413694/bin/pone.0041934.s009.pdf
Authors & Co-Authors
Young, Sera L.
United States, Ithaca
Cornell University
Murray, Katherine
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Mwesigwa, Julia
Uganda, Kampala
Makerere University
Natureeba, Paul
Uganda, Kampala
Makerere University
Osterbauer, Beth
United States, San Francisco
Ucsf School of Medicine
Achan, Jane
Uganda, Kampala
Makerere University College of Health Sciences
Arinaitwe, Emmanuel S.
Uganda, Kampala
Makerere University
Clark, Tamara D.
United States, San Francisco
Ucsf School of Medicine
Ades, Veronica
United States, San Francisco
University of California, San Francisco
Plenty, Albert H.J.
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Charlebois, Edwin D.
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Ruel, Theodore D.
United States, San Francisco
University of California, San Francisco
Kamya, Moses Robert K.
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Havlir, Diane V.
United States, San Francisco
Ucsf School of Medicine
Cohan, Deborah L.
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 55
Authors: 15
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0041934
e-ISSN:
19326203
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Locations
Uganda
Participants Gender
Female