title: A multicenter study of diet quality on birth weight and gestational age in infants of HIV-infected women.
abstract: We determined factors associated with diet quality and assessed the relationship between diet quality, birth weight, and gestational age in a prospective national multicenter cohort study. We evaluated diet quality with the Healthy Eating Index (HEI, scale 0-100) in the third trimester of pregnancy with three 24-hr multiple-pass dietary recalls in 266 HIV+ women enrolled in the Pediatric HIV/AIDS Cohort Study. Covariates included demographics, food security, pre-pregnancy body mass index, HIV disease severity, substance use, and antiretroviral exposures. A two-stage multivariate process using classification and regression trees (CART) followed by multiple regression described HEI tendencies, controlled possible confounding effects, and examined the association of HEI with birth weight and gestational age. To assess the stability of the CART solution, both the HEI 2005 and 2010 were evaluated. The mean HEI scores were 56.1 and 47.5 for the 2005 and 2010 HEI, respectively. The first-stage CART analysis examined the relationship between HEI and covariates. Non-US born versus US-born mothers had higher HEI scores (15-point difference, R2= 0.28). There was a secondary partition due to alcohol/cigarette/illicit drug usage (3.5-point difference, R2= 0.03) among US-born women. For the second-stage CART adjusted multiple regression, birth weight z-score was positively related to HEI 2005 and 2010 (partial r's > 0.13, P's ≤ 0.0398), but not gestational age (r = 0.00). We conclude that diet quality among HIV+ women is associated with higher birth weight. Despite the influence of a large cultural effect and poor prenatal behaviors, interventions to improve diet in HIV+ women may help to increase birth weight.
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: Tracie L
authors.initials: TL
authors.lastname: Miller
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Denise L
authors.initials: DL
authors.lastname: Jacobson
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Somarriba
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Neri
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Kurtz-Vraney
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Graham
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Department of Orthopedic Surgery, University of Chicago Medical Center, Chicago, Illinois, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Landy
authors.affiliation: Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Siminski
authors.affiliation: Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Butler
authors.affiliation: Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Rich
authors.affiliation: Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA.
authors.forename: Kristy
authors.initials: K
authors.lastname: Hendricks
authors.affiliation: Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Ludwig
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001724:Birth Weight; D015992:Body Mass Index; D000072001:Diet, Healthy; D005260:Female; D005865:Gestational Age; D015658:HIV Infections; D006801:Humans; D007223:Infant; D039382:Maternal Nutritional Physiological Phenomena; D011939:Mental Recall; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011264:Pregnancy Trimesters; D011446:Prospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: HIV; birth weight; dietary quality; healthy eating index; pregnancy