title: Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe.
abstract: The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd-35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66.3%) women, of which 360 (32.5%) had HIV infection. Mean gestation length was 39.1 weeks with 16.6% <37 weeks, mean birth weight was 3030 g with 10.5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0.005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.
authors.affiliation: Department of Epidemiology, Institute of Public Health, University of Copenhagen, DK-2200 Copenhagen N, Denmark. h.friis@pubhealth.ku.dk
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.forename: Exnevia
authors.initials: E
authors.lastname: Gomo
authors.forename: Norman
authors.initials: N
authors.lastname: Nyazema
authors.forename: Patricia
authors.initials: P
authors.lastname: Ndhlovu
authors.forename: Henrik
authors.initials: H
authors.lastname: Krarup
authors.forename: Pernille
authors.initials: P
authors.lastname: Kaestel
authors.forename: Kim Fleischer
authors.initials: KF
authors.lastname: Michaelsen
mesh_terms: D000273:Adipose Tissue / Q000502:physiology; D000328:Adult; D001724:Birth Weight; D001823:Body Composition / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D020073:Gravidity / Q000502:physiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011272:Pregnancy, Multiple / Q000502:physiology; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors; D019562:Viral Load; D015030:Zimbabwe / Q000453:epidemiology