title: Maternal vitamin D status and child morbidity, anemia, and growth in human immunodeficiency virus-exposed children in Tanzania.
abstract: BACKGROUND
  Vitamin D may help prevent adverse pediatric outcomes, including infectious diseases and growth failure, based on its role in immune and metabolic functions. We examined the association of maternal vitamin D status and pediatric health outcomes in children born to human immunodeficiency virus (HIV)-infected women.
  
  
  METHODS
  Vitamin D status was determined in 884 HIV-infected pregnant women at 12 to 27 weeks of gestation in a trial of vitamin supplementation (not excluding vitamin D) in Tanzania. Information on child morbidities, anemia and hypochromic microcytosis, and anthropometry was recorded through monthly clinic visits. Generalized estimating equations and Cox proportional hazards models were used to assess the relationships of outcomes with maternal vitamin D status.
  
  
  RESULTS
  A total of 39% of women had low vitamin D levels (<32 ng/mL). Children born to women with low vitamin D status were 1.11 times more likely to report cough during follow-up (relative risk [RR], 1.11; 95% confidence interval [CI], 1.02-1.21). No significant associations were noted for other respiratory symptoms, diarrhea, or anemia outcomes. Low maternal vitamin D status was associated with significantly increased risk of stunting (height-for-age z score, <-2; RR, 1.29; 95% CI, 1.05-1.59) and being underweight (weight-for-age z score, <-2; RR, 1.33; 95% CI, 1.03-1.71).
  
  
  CONCLUSIONS
  Maternal vitamin D status may be important for preventing respiratory infections and ensuring optimal growth in HIV-exposed children.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. jfinkelstein@cornell.edu
authors.forename: Julia L
authors.initials: JL
authors.lastname: Finkelstein
authors.forename: Saurabh
authors.initials: S
authors.lastname: Mehta
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
authors.forename: Karim P
authors.initials: KP
authors.lastname: Manji
authors.forename: Ferdinand M
authors.initials: FM
authors.lastname: Mugusi
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Gernard I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D000747:Anemia, Hypochromic / Q000453:epidemiology*; D000886:Anthropometry; D002657:Child Development; D005260:Female; D006128:Growth; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D013223:Statistics as Topic; D013636:Tanzania; D014807:Vitamin D / Q000097:blood*; D055815:Young Adult
chemical_list: D014807:Vitamin D