Elevated body mass index during pregnancy and gestational weight gain in HIV-infected and HIV-uninfected women in Cape Town, South Africa: association with adverse birth outcomes
Elevated body mass index during pregnancy and gestational weight gain in HIV-infected and HIV-uninfected women in Cape Town, South Africa: association with adverse birth outcomes
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DOI：
10.1111/tmi.13387
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发表时间：
2020-03-23
影响因子：
3.3
通讯作者：
Myer, Landon
中科院分区：
文献类型：
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作者：
Madlala, Hlengiwe P.;Malaba, Thokozile R.;Myer, Landon
目的探讨孕妇体重指数（BMI）和妊娠期体重增加（GWG）和不良出生结局在HIV感染和HIV-uninfected women.Methods在南非城市社区，2921连续HIV感染和HIV-uninfected孕妇参加初级保健服务进行了评估，在他们的第一次产前检查之间的关联。在一项纵向研究中，对一组感染艾滋病毒的妇女在怀孕期间进行了三次评估。所有妇女都有来自医疗记录和研究问卷的出生结果数据。在分析中，BMI，GWG，母亲因素和不良的出生outcomes. Results之间的关联进行了评估的logistic回归models.Results估计的孕前BMI中位数为29 kg/m2（IQR，24-34）的整体，29 kg/m2（IQR，24-34）的HIV未感染和28 kg/m2（IQR，24-34）的HIV感染的妇女; HIV患病率为38%。在调整后的模型中，整个队列中BMI的增加与首次产前访视时的年龄、血红蛋白和产次呈正相关。母亲肥胖与高出生体重（aOR 2.54，95% CI 1.39-4.66）和胎龄大（aOR 1.66，95% CI 1.20-2.31）婴儿的可能性增加相关。在亚组队列中，GWG与自发性早产（aOR 4.35，95%CI 1.55-12.21）和高出生体重（aOR 3.00，95%CI 1.22-7.34）infants.Conclusion肥胖在妊娠期是普遍存在的，并出现与HIV感染和未感染的妇女不良出生结局的风险增加。需要针对育龄妇女的体重管理干预措施，以促进健康怀孕和减少不良生育结果。
Objectives To examine the association between maternal body mass index (BMI) and gestational weight gain (GWG) and adverse birth outcomes in HIV-infected and HIV-uninfected women.Methods In an urban South African community, 2921 consecutive HIV-infected and HIV-uninfected pregnant women attending primary healthcare services were assessed at their first antenatal visit. A subset of HIV-infected women enrolled in a longitudinal study was assessed three times during pregnancy. All women had birth outcome data from medical records and study questionnaires. In analyses, the associations between BMI, GWG, maternal factors and adverse birth outcomes were assessed with logistic regression models.Results The estimated pre-pregnancy BMI median was 29 kg/m(2) (IQR, 24-34) overall, 29 kg/m(2) (IQR, 24-34) for HIV-uninfected and 28 kg/m(2) (IQR, 24-34) for HIV-infected women; HIV prevalence was 38%. In adjusted models, increased BMI in the overall cohort was positively associated with age, haemoglobin and parity at first antenatal visit. Maternal obesity was associated with increased likelihood of having high birthweight (aOR 2.54, 95% CI 1.39-4.66) and large size for gestational age (aOR 1.66, 95% CI 1.20-2.31) infants. In the subset cohort, GWG was associated with increased likelihood of spontaneous preterm delivery (aOR 4.35, 95% CI 1.55-12.21) and high birthweight (aOR 3.00, 95% CI 1.22-7.34) infants.Conclusion Obesity during pregnancy is prevalent in this setting and appears associated with increased risk of adverse birth outcomes in both HIV-infected and HIV-uninfected women. Weight management interventions targeting women of child-bearing age are needed to promote healthy pregnancies and reduce adverse birth outcomes.