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HIV infection is associated with a lower rate of gestational weight gain and reduced neonatal length
Author(s) -
Natamba Barnabas Kahiira,
Vermeylen Francoise,
Young Sera L,
Griffiths Jeffrey K,
Bran Patsy M,
Mehta Saurabh
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.lb399
Subject(s) - medicine , weight gain , obstetrics , pregnancy , cohort , gestational age , gestation , birth weight , cohort study , human immunodeficiency virus (hiv) , pediatrics , body weight , immunology , genetics , biology
Background Adequate gestational weight gain (GWG) and neonatal growth are important, respectively, for favorable birth outcomes and survival of infants through the first year. In sub‐Saharan Africa, underlying infections, such as HIV, may adversely impact GWG and neonatal growth. We investigated trends in GWG among HIV‐infected and ‐uninfected women in northern Uganda; and, examined growth parameters of their HIV‐exposed and ‐unexposed neonates. Methods 403 (133 HIV‐infected and on treatment vs. 270 ‐uninfected) pregnant women were recruited into this study from the antenatal clinic of Gulu Hospital. Women's height and weight were measured at enrollment (mean (±SD) gestational age =19.4 (±−3.8) weeks) and weight was measured at each follow‐up visit. After delivery, a subsample (n=246) of dyads was enrolled into a postnatal cohort. At one month postpartum, length and weight were measured and growth indicators (HAZ, WAZ and WHZ) were evaluated using the 2006 WHO standards. Other important variables were documented at recruitment using a detailed questionnaire. Multivariate regression models were employed to determine whether HIV status was associated with 1) the weekly rate of GWG and 2) neonatal indicators of growth. Results Adjusted models indicated a quadratic trend in GWG in both HIV infected and uninfected pregnant women. The rate of GWG among HIV infected women was significantly lower than that of HIV uninfected women (p=0.001). Prenatal HIV exposure was associated with significantly lower HAZ (p=0.013) and a nonsignicant trend towards lower WAZ; but, HIV exposure was not associated with WHZ at one month postpartum. HIV‐exposed neonates were more likely to be stunted (HAZ≤−2) than those who were –unexposed (adjusted odds ratio (aOR) (95%CI): 3.48 (1.29; 9.40). Conclusion These results provide strong justifications for studies to understand mechanisms that underlay the negative effects of HIV infection or exposure on gestational weight gain and linear growth of HIV exposed neonates in this context. Support or Funding Information This research was funded in part by Cornell University Weill Medical College Intercampus Seed Funds, K01 MH098902 from NIMH and USAID Cooperative Agreement AIDOAAL16