Dietary Intakes and patterns, biomarkers, and maternal and infant outcomes in HIV

母体营养环境影响妊娠结局和胎儿生长，并且有证据表明其对产后结局的影响可以持续到儿童和成年。三分之二以上感染艾滋病毒的孕妇有并发症。还有人担心，艾滋病毒暴露，但未感染的儿童可能有问题的增长和神经认知。这些并发症可能是多因素的，可能与ART和药物滥用有关。然而，评价感染艾滋病毒妇女的母亲饮食的全面数据有限，特别是关于饮食模式、食物类别和已知影响怀孕、围产期和婴儿结果的特定微量和大量营养素。本研究将利用NICHD资助的儿科HIV/AIDS队列研究（PHACS）的基础设施来评估饮食参数及其与母婴结局的相关性。我们将专门评估乳制品和鱼类食品组以及特定的多不饱和脂肪摄入量（n-3，n-6和比率），铁和维生素D。我们的主要目标是：1。描述艾滋病毒感染妇女怀孕第三个三个月的饮食模式、食物类别和营养摄入; 2.确定这些饮食因素之间的关联，在怀孕和怀孕，围产期，和婴儿的结果; 3.确定铁和维生素D的母体生物标志物的特定关联，炎症标志物（hs-CRP）对我们感兴趣的结果。我们将招募230名女性（目标是分析200名），在未来2年内入组SMARTT方案。我们将在其妊娠晚期进行3次电话管理的24小时饮食召回，并获取25- 0 H维生素D、hs-CRP、铁研究和钙的血液样本（并将储存血液）。我们将记录妊娠和围产期并发症（根据PHACS方案），并将获得2-24小时的饮食回忆、神经认知发育和1岁内的生长评估（并非所有儿童在2年补助期内都将达到1岁;但足够数量[20%]的儿童将具有该特定终点的可分析1年结局）。有了这些信息，我们将能够确定产妇饮食与1。怀孕，2。围产期和3.艾滋病毒感染妇女的早期婴儿结果，以便为怀孕期间感染艾滋病毒的妇女提供适当的营养建议。

The maternal nutrient environment influences pregnancy outcomes and fetal growth, and there is evidence of its impact on postnatal outcomes that can persist into childhood and adulthood. Over 2/3 of the pregnancies of HIV-infected women have complications. There is also concern that HIV-exposed, but uninfected children can have problems with growth and neurocognition. These complications are likely multifactorial and may be related to ART and substance abuse. However, there are limited comprehensive data evaluating maternal diets of HIV-infected women with particular reference to dietary patterns, food groups and specific micro and macronutrients known to impact on pregnancy, perinatal, and infant outcomes. This study, will take advantage of the NICHD-funded Pediatric HIV/AIDS Cohort Study (PHACS) infrastructure to evaluate dietary parameters and associations with maternal and infant outcomes. We will specifically evaluate the dairy and fish food groups as well as specific polyunsaturated fat intakes (n-3, n-6 and ratios), iron and vitamin D. Our main objectives are to: 1. characterize dietary patterns, food groups and nutrient intake in the 3rd trimester of pregnancy in HIV-infected women; 2. determine the associations between these dietary factors in pregnancy and pregnancy, perinatal, and infant outcomes and; 3. determine the specific associations of maternal biomarkers of iron and vitamin D, a marker of inflammation (hs-CRP) on our outcomes of interest. We will recruit 230 women (with goal of analyzing 200) who are enrolled in the SMARTT protocol over the next 2 years. We will obtain 3 telephone administered 24 hour diet recalls during their 3rd trimester of pregnancy and obtain a blood sample for 25-0H vitamin D, hs-CRP, iron studies, and calcium (and will bank blood). We will record pregnancy and perinatal complications (per the PHACS protocol) and will obtain 2-24 hour diet recalls, neurocognitive development and growth assessments through the 1 st year of life (not all children will reach 1 yr during this 2-year grant interval; but a sufficient number [20%] will have analyzable 1 year outcomes for this specific endpoint). With this information, we Will be able to determine associations between maternal diet and 1. pregnancy, 2. perinatal and 3. early infant outcomes in women with HIV so that appropriate nutritional recommendations can be made for HIV-infected women in pregnancy.