Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.
Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.
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DOI：
10.1371/journal.pone.0041934
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Cohan D
中科院分区：
文献类型：
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作者：
Young S;Murray K;Mwesigwa J;Natureeba P;Osterbauer B;Achan J;Arinaitwe E;Clark T;Ades V;Plenty A;Charlebois E;Ruel T;Kamya M;Havlir D;Cohan D
产妇营养状况是分娩结局的重要预测因素，但对接受抗逆转录病毒联合治疗（cART）的艾滋病毒感染孕妇的营养状况知之甚少。因此，我们研究了乌干达农村166名开始cART的妇女在研究入组时的母亲BMI、妊娠体重增加（GWG）和血红蛋白浓度（Hb）之间的关系。前瞻性群组。hiv感染的ART-naïve孕妇在妊娠12 - 28周期间入组，接受蛋白酶抑制剂或非核苷逆转录酶抑制剂联合治疗。每月评估营养状况。新生儿出生时进行人体测量。使用多变量分析评估结果。平均GWG为0.17 kg/周，14.6%的妇女在怀孕期间体重减轻，44.9%的妇女贫血。不良胎儿结局包括低出生体重（LBW）（19.6%）、早产（17.7%）、死胎（3.9%）、发育迟缓（21.1%）、胎龄小（15.1%）和保头生长受限（26%）。没有婴儿感染艾滋病毒。体重增加<0.1 kg/周与低体重、早产和综合不良产科/胎儿结局相关。妊娠7个月时母亲体重预测LBW。平均血红蛋白每升高1 g/dL，小胎龄的几率降低52%。在我们的hiv感染妇女队列中，在怀孕期间开始cART，严重不足的GWG是常见的。母亲每周体重增加<0.1 kg的婴儿发生低体重、早产和综合不良出生结局的风险增加。cART本身可能不足以减轻感染艾滋病毒妇女不良分娩结果的负担。Clinicaltrials.gov NCT00993031
Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Prospective cohort. HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%. In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Clinicaltrials.gov NCT00993031
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影响因子：
105.7
作者：
Ceesay, SM;Prentice, AM;Whitehead, RG
通讯作者：
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DOI：
10.1097/01.qai.0000188122.15493.0a
发表时间：
2006-04-01
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作者：
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DOI：
10.1111/j.1749-6632.2010.05657.x
发表时间：
2010-01-01
期刊：
WOMEN'S HEALTH AND DISEASE
影响因子：
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作者：
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通讯作者：
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DOI：
10.1111/j.1471-0528.1989.tb03285.x
发表时间：
1989-06-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
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作者：
ALGHAZALI, W;CHITA, SK;ALLAN, LD
通讯作者：
ALLAN, LD