Abstract
We describe change in weight, midupper arm circumference (MUAC), arm muscle area (AMA) and arm fat area (AFA) in 1130 pregnant
HIV-infected women with CD4 counts > 200 as part of the BAN Study (www.thebanstudy.org), a randomized, controlled clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child
transmission of HIV during breast feeding. In a longitudinal analysis, we found a linear increase in weight with a mean rate
of weight gain of 0.27 kgs/week, from baseline (12 to 30 weeks gestation) until the last follow-up visit (32–38 weeks). Analysis
of weight gain showed that 17.1% of the intervals between visits resulted in a weight loss. In unadjusted models, MUAC and
AMA increased and AFA declined during late pregnancy. Based on multivariable regression analysis, exposure to the famine season
resulted in larger losses in AMA [−0.08, 95% CI −0.14, −0.02; p = 0.01] while AFA losses occurred irrespective of season [−0.55,
95%: −0.95, −0.14, p = 0.01]. CD4 was associated with AFA [0.21, 95% CI 0.01, 0.41, p = .04]. Age was positively associated
with MUAC and AMA. Wealth was positively associated with MUAC, AFA, and weight. While patterns of anthropometric measures
among HIV-infected, pregnant women were found to be similar to those reported for uninfected women in sub-Saharan Africa,
effects of the famine season among undernourished, Malawian women are of concern. Strategies to optimize nutrition during
pregnancy for these women appear warranted.
HIV-infected women with CD4 counts > 200 as part of the BAN Study (www.thebanstudy.org), a randomized, controlled clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child
transmission of HIV during breast feeding. In a longitudinal analysis, we found a linear increase in weight with a mean rate
of weight gain of 0.27 kgs/week, from baseline (12 to 30 weeks gestation) until the last follow-up visit (32–38 weeks). Analysis
of weight gain showed that 17.1% of the intervals between visits resulted in a weight loss. In unadjusted models, MUAC and
AMA increased and AFA declined during late pregnancy. Based on multivariable regression analysis, exposure to the famine season
resulted in larger losses in AMA [−0.08, 95% CI −0.14, −0.02; p = 0.01] while AFA losses occurred irrespective of season [−0.55,
95%: −0.95, −0.14, p = 0.01]. CD4 was associated with AFA [0.21, 95% CI 0.01, 0.41, p = .04]. Age was positively associated
with MUAC and AMA. Wealth was positively associated with MUAC, AFA, and weight. While patterns of anthropometric measures
among HIV-infected, pregnant women were found to be similar to those reported for uninfected women in sub-Saharan Africa,
effects of the famine season among undernourished, Malawian women are of concern. Strategies to optimize nutrition during
pregnancy for these women appear warranted.
- Content Type Journal Article
- Pages 1-9
- DOI 10.1007/s10995-012-0970-6
- Authors
- Roshan T. Ramlal, University of North Carolina, Chapel Hill, NC, USA
- Martin Tembo, UNC Project, Lilongwe, Malawi
- Alice Soko, UNC Project, Lilongwe, Malawi
- Maggie Chigwenembe, UNC Project, Lilongwe, Malawi
- Beth C. Tohill, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Dumbani Kayira, UNC Project, Lilongwe, Malawi
- Caroline C. King, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Charles Chasela, UNC Project, Lilongwe, Malawi
- Denise Jamieson, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Charles van der Horst, University of North Carolina, Chapel Hill, NC, USA
- Margaret E. Bentley, University of North Carolina, Chapel Hill, NC, USA
- Linda S. Adair, University of North Carolina, Chapel Hill, NC, USA
- the BAN Study Team
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875