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Determinants of low birth weight among HIV-infected pregnant women in Tanzania.
Am J Clin Nutr. 2001 Dec; 74(6):814-26.AJ

Abstract

BACKGROUND

Low birth weight (LBW) increases the risk of infant death, but little is known about its causes among HIV-infected populations in sub-Saharan Africa.

OBJECTIVE

We assessed sociodemographic, nutritional, immunologic, parasitic, and infant risk factors for birth weight, LBW, and small-for-gestational-age (SGA) status in a cohort of 822 HIV-positive women enrolled in a clinical trial of vitamin supplementation and pregnancy outcomes in Dar es Salaam, Tanzania.

DESIGN

Women were enrolled at prenatal care clinics during their second trimester, at which time blood, stool, urine, and genital specimens were collected, and anthropometric measurements and sociodemographic data were recorded. Birth weight was measured at hospital delivery.

RESULTS

The mean (+/-SD) birth weight was 3015 +/- 508 g, 11.1% of newborns weighed <2500 g (LBW), and 11.5% were SGA. In multivariate analyses, maternal weight at enrollment and a low CD8 cell count were inversely associated with LBW. Advanced-stage HIV disease, previous history of preterm birth, Plasmodium falciparum malaria, and any helmintic infection were associated with higher risk of LBW. The intestinal parasites Entamoeba histolytica and Strongyloides stercoralis were predictors of LBW despite their low prevalence in the cohort. In a multivariate-adjusted linear regression model, BMI, midupper arm circumference, a CD4 cell count <200 x 10(6) cells/L (200 cells/mm(3)), primiparity, maternal literacy, and infant HIV infection at birth were significantly associated with birth weight in addition to risk factors included in the LBW model. Determinants of SGA included maternal weight, low serum vitamin E concentration, candidiasis, malaria, and infant HIV infection at birth.

CONCLUSION

Prevention of HIV disease progression and vertical transmission, improved nutritional status, and better management of malaria and intestinal parasitic infections are likely to reduce the incidence of LBW in Tanzania.

Authors+Show Affiliations

Departments of Nutrition, Biostatistics, and Epidemiology, Harvard School of Public Health, Boston, MA, USA. mdreyfus@jhsph.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11722965

Citation

Dreyfuss, M L., et al. "Determinants of Low Birth Weight Among HIV-infected Pregnant Women in Tanzania." The American Journal of Clinical Nutrition, vol. 74, no. 6, 2001, pp. 814-26.
Dreyfuss ML, Msamanga GI, Spiegelman D, et al. Determinants of low birth weight among HIV-infected pregnant women in Tanzania. Am J Clin Nutr. 2001;74(6):814-26.
Dreyfuss, M. L., Msamanga, G. I., Spiegelman, D., Hunter, D. J., Urassa, E. J., Hertzmark, E., & Fawzi, W. W. (2001). Determinants of low birth weight among HIV-infected pregnant women in Tanzania. The American Journal of Clinical Nutrition, 74(6), 814-26.
Dreyfuss ML, et al. Determinants of Low Birth Weight Among HIV-infected Pregnant Women in Tanzania. Am J Clin Nutr. 2001;74(6):814-26. PubMed PMID: 11722965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants of low birth weight among HIV-infected pregnant women in Tanzania. AU - Dreyfuss,M L, AU - Msamanga,G I, AU - Spiegelman,D, AU - Hunter,D J, AU - Urassa,E J, AU - Hertzmark,E, AU - Fawzi,W W, PY - 2001/11/28/pubmed PY - 2002/1/5/medline PY - 2001/11/28/entrez SP - 814 EP - 26 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 74 IS - 6 N2 - BACKGROUND: Low birth weight (LBW) increases the risk of infant death, but little is known about its causes among HIV-infected populations in sub-Saharan Africa. OBJECTIVE: We assessed sociodemographic, nutritional, immunologic, parasitic, and infant risk factors for birth weight, LBW, and small-for-gestational-age (SGA) status in a cohort of 822 HIV-positive women enrolled in a clinical trial of vitamin supplementation and pregnancy outcomes in Dar es Salaam, Tanzania. DESIGN: Women were enrolled at prenatal care clinics during their second trimester, at which time blood, stool, urine, and genital specimens were collected, and anthropometric measurements and sociodemographic data were recorded. Birth weight was measured at hospital delivery. RESULTS: The mean (+/-SD) birth weight was 3015 +/- 508 g, 11.1% of newborns weighed <2500 g (LBW), and 11.5% were SGA. In multivariate analyses, maternal weight at enrollment and a low CD8 cell count were inversely associated with LBW. Advanced-stage HIV disease, previous history of preterm birth, Plasmodium falciparum malaria, and any helmintic infection were associated with higher risk of LBW. The intestinal parasites Entamoeba histolytica and Strongyloides stercoralis were predictors of LBW despite their low prevalence in the cohort. In a multivariate-adjusted linear regression model, BMI, midupper arm circumference, a CD4 cell count <200 x 10(6) cells/L (200 cells/mm(3)), primiparity, maternal literacy, and infant HIV infection at birth were significantly associated with birth weight in addition to risk factors included in the LBW model. Determinants of SGA included maternal weight, low serum vitamin E concentration, candidiasis, malaria, and infant HIV infection at birth. CONCLUSION: Prevention of HIV disease progression and vertical transmission, improved nutritional status, and better management of malaria and intestinal parasitic infections are likely to reduce the incidence of LBW in Tanzania. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/11722965/Determinants_of_low_birth_weight_among_HIV_infected_pregnant_women_in_Tanzania_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/74.6.814 DB - PRIME DP - Unbound Medicine ER -