Subclinical mastitis among HIV-infected and uninfected Zimbabwean women participating in a multimicronutrient supplementation trial
Subclinical mastitis among HIV-infected and uninfected Zimbabwean women participating in a multimicronutrient supplementation trial
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DOI：
10.1016/s0035-9203(03)90124-6
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发表时间：
2003-03-01
影响因子：
2.2
通讯作者：
Friis, H
中科院分区：
文献类型：
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作者：
Gomo, E;Filteau, SM;Friis, H
亚临床乳腺炎，定义为牛奶钠/钾（Na/K）比值升高，是常见的，与婴儿生长不良和母婴艾滋病毒传播增加有关。在1996- 1997年，我们进行了一项随机对照试验，从妊娠22 - 35周到产后3个月，以推荐的每日摄入量补充多种微量营养素，研究84名艾滋病毒感染者和83名未感染艾滋病毒的津巴布韦哺乳期妇女中亚临床乳腺炎的患病率和严重程度及其婴儿的生长情况。产后4.5个月前采集的母乳样品，用火焰光度法分析Na/K比值。HIV感染和未感染妇女的隐性乳房炎患病率无显著差异。在控制采样时的婴儿年龄后，补充微量营养素的HIV感染妇女的Na/K几何平均值无显著（P = 0.08）降低。比率（0.43，95% CI 0.35-0.51）高于接受安慰剂的HIV感染妇女（0.51，95% CI 0.42-0.61）。补充营养素对未感染HIV的妇女的隐性乳房炎患病率没有影响（比值比[OR] = 1.26，95%CI 0.45-3.51，P = 0.80），但在感染HIV的妇女中，其患病率出现临界下降（OR = 2.82，95%CI 0.96-8.26，P = 0.07）。母乳钠/钾比值较高的妇女在1.5至4.5个月之间的婴儿体重较低。因此，亚临床乳腺炎对婴儿生长的重要性表明，有必要进一步研究，以减少条件，也许使用更高的微量营养素剂量。
Subclinical mastitis, defined as raised milk sodium/potassium (Na/K) ratio is common and associated with poor infant growth and increased mother-to-child HIV transmission. In 1996-97, we conducted a randomized controlled trial of multiple micronutrient supplementation, at recommended daily allowance levels, from 22 to 35 weeks gestation until 3 months post-partum, on the prevalence and severity of subclinical mastitis among 84 HIV-infected and 83 HIV-uninfected lactating Zimbabwean women and on their infants' growth. Spot milk samples collected before 4.5 months post-partum were analysed for Na/K ratio by flame photometry. There was no significant difference in prevalence of subclinical mastitis between HIV-infected and HIV-uninfected women. After controlling for infant age at time of sampling, micronutrient-supplemented HIV-infected women had non-significantly (P = 0.08) lower geometric mean Na/K. ratio (0.43, 95% CI 0.35-0.51) than HIV-infected women given placebo (0.51, 95% CI 0.42-0.61). Micronutrient supplementation had no effect on the prevalence of subclinical mastitis among HIV-uninfected women (odds ratio [OR] = 1.26, 95% CI 0.45-3.51, P = 0.80) but induced a borderline decrease in prevalence (OR = 2.82, 95% CI 0.96-8.26, P = 0.07) among HIV-infected women. Infant weight between 1.5 and 4.5 months was lower in women with higher milk Na/K ratio. Thus, the importance of subclinical mastitis for infant growth suggests that further investigations to decrease the condition, perhaps using higher micronutrient doses, are warranted.