Weight gain during pregnancy among women initiating dolutegravir in Botswana.
Weight gain during pregnancy among women initiating dolutegravir in Botswana.
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DOI：
10.1016/j.eclinm.2020.100615
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发表时间：
2020-12
影响因子：
15.1
通讯作者：
Zash R
中科院分区：
文献类型：
--
作者：
Caniglia EC;Shapiro R;Diseko M;Wylie BJ;Zera C;Davey S;Isaacson A;Mayondi G;Mabuta J;Luckett R;Makhema J;Mmalane M;Lockman S;Zash R
最近的数据表明，在开始基于度鲁特韦的ART（DTG）后，非妊娠HIV阳性成人的体重增加具有临床意义。怀孕期间体重增加过多或不足可能会对妊娠结局产生不利影响，但接受DTG的孕妇的数据有限。Tsepamo研究收集了2014年至2019年博茨瓦纳交付地点的数据。艾滋病毒检测，艾滋病毒治疗的信息，并在产前护理体重测量提取的产妇分娩记录。在妊娠至17周期间开始DTG或基于依法韦仑的ART（EFV）的HIV阳性女性和在妊娠17周之前首次接受产前护理的HIV未感染女性均纳入研究。我们评估了每周体重增加，18周总体重增加，体重增加过多（>0.59 kg/周），体重增加不足（<0.18 kg/周），以及妊娠18±2周和36±2周之间的体重减轻，调整人口统计学和临床变量。各暴露组的基线特征相似，包括孕前和孕早期体重。与EFV相比，开始DTG的女性在妊娠18 - 36周期间的平均每周体重增加量高0.05（95% CI 0.03，0.07）kg/周，未感染HIV的女性高0.12（0.10，0.14）kg/周。与EFV相比，开始DTG的女性平均18周体重增加1.05（95% CI 0.61，1.49）kg，未感染HIV的女性平均18周体重增加2.31（1.85，2.77）kg。开始DTG的女性比开始EFV的女性更容易增加体重，但不太可能增加体重不足或减轻体重。与EFV相比，在妊娠期间开始DTG的妇女在妊娠18至36周之间体重增加更多。这两组人的体重都没有未感染艾滋病毒的妇女增加。与EFV相比，在妊娠期间启动DTG可能会增加体重增加过多的风险，但会降低体重增加不足和体重减轻的风险，这可能会对妊娠产生积极和消极的影响。我们的研究结果与先前在非妊娠成年人中的研究一致。
Recent data suggests clinically significant weight gain among non-pregnant HIV-positive adults after starting dolutegravir-based ART (DTG). Excess or insufficient weight gain in pregnancy could adversely impact pregnancy outcomes, but data for pregnant women receiving DTG are limited. The Tsepamo Study captured data at delivery sites in Botswana from 2014 to 2019. HIV testing, HIV treatment information, and weight measurements during antenatal care were abstracted from the maternity obstetric record at delivery. HIV-positive women initiating DTG or efavirenz-based ART (EFV) between conception and 17 weeks gestation and HIV-uninfected women first presenting for antenatal care before 17 weeks gestation were included. We evaluated weekly weight gain, total 18-week weight gain, excess weight gain (>0.59 kg/week), insufficient weight gain (<0.18 kg/week), and weight loss between 18±2 and 36±2 weeks gestation, adjusting for demographic and clinical variables. Baseline characteristics were similar by exposure group, including pre-pregnancy and early pregnancy weight. Compared with EFV, mean weekly weight gain between 18 and 36 weeks gestation was 0.05 (95% CI 0.03, 0.07) kg/week higher for women initiating DTG and 0.12 (0.10, 0.14) kg/week higher for HIV-uninfected women. Mean 18-week weight gain was 1.05 (95% CI 0.61, 1.49) kg higher for women initiating DTG and 2.31 (1.85, 2.77) kg higher for HIV-uninfected women, compared with EFV. Women initiating DTG were more likely to gain excess weight but less likely to gain insufficient weight or lose weight than women initiating EFV. Women initiating DTG compared with EFV during pregnancy gained more weight between 18 and 36 weeks gestation. Neither group gained as much weight as HIV-uninfected women. Initiating DTG compared with EFV during pregnancy could increase the risk of excess weight gain but decrease the risk of insufficient weight gain and weight loss, which could have positive and negative consequences in pregnancy. Our findings are consistent with prior studies in non-pregnant adults.
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影响因子：
120.7
作者：
Gunthard, Huldrych F.;Saag, Michael S.;Benson, Constance A.;del Rio, Carlos;Eron, Joseph J.;Gallant, Joel E.;Hoy, Jennifer F.;Mugavero, Michael J.;Sax, Paul E.;Thompson, Melanie A.;Gandhi, Rajesh T.;Landovitz, Raphael J.;Smith, Davey M.;Jacobsen, Donna M.;Volberding, Paul A.
通讯作者：
Volberding, Paul A.
DOI：
10.1097/ede.0000000000000629
发表时间：
2017-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
MacDonald SC;Bodnar LM;Himes KP;Hutcheon JA
通讯作者：
Hutcheon JA
影响因子：
11.8
作者：
Gatell, Jose M.;Assoumou, Lambert;Johnston, Sarah
通讯作者：
Johnston, Sarah
影响因子：
11.8
作者：
Yuh, Bianca;Tate, Janet;Justice, Amy C.
通讯作者：
Justice, Amy C.
影响因子：
158.5
作者：
Ayouba, A.;Butel, C.;Casa, C. Perez
通讯作者：
Casa, C. Perez