Pattern and predictors of weight gain during pregnancy among HIV-1-infected women from Tanzania.
Progression of HIV disease is often accompanied by weight loss and wasting. Gestational weight gain is a strong determinant of maternal and neonatal outcomes; however, the pattern and predictors of weight gain during pregnancy among HIV-positive women are unknown. We obtained monthly anthropometric measurements in a cohort of 957 pregnant women from Tanzania who were HIV infected. We estimated the weekly rate of weight gain at various points during the second and third trimesters of pregnancy and computed rate differences between levels of sociodemographic, nutritional, immunologic, and parasitic variables at the first prenatal visit. The change in mid-upper arm circumference (MUAC) from baseline to delivery was also examined. The rate of weight gain decreased progressively during pregnancy. There was an average decline of 1 cm in MUAC between weeks 12 and 38. Lower level of education and helminthic infections at first visit were associated with decreased adjusted rates of weight gain during the third trimester. High baseline MUAC, not contributing to household income, lower serum retinol and selenium concentrations, advanced clinical stage of HIV disease, and malaria infection were related to decreased rates of weight gain during the second trimester. Low baseline CD4 T-cell counts were related to a poorer pattern of weight gain throughout pregnancy. Prevention and treatment of parasitic infections and improvement of nutritional status are likely to enhance the pattern of gestational weight gain among HIV-infected women.
Villamor
Eduardo
E
Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, U.S.A. evillamo@hsph.harvard.edu
Msamanga
Gernard
G
Spiegelman
Donna
D
Peterson
Karen E
KE
Antelman
Gretchen
G
Fawzi
Wafaie W
WW
D001132:Arm / Q000502:physiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications / Q000188:drug therapy; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy / Q000469:parasitology; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D013636:Tanzania; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use; D015430:Weight Gain / Q000502:physiology*
D014815:Vitamins; D014801:Vitamin A