Journal Article

Patterns of Body Composition Among HIV-Infected, Pregnant Malawians and the Effects of Famine Season

Kayira, Dumbani, van der Horst, Charles, Jamieson, Denise, Tembo, Martin, Soko, Alice, Chigwenembe, Maggie, Adair, Linda S., Tohill, Beth C., Chasela, Charles, Ramlal, Roshan T., King, Caroline C., Bentley, Margaret E.

2013

Overview

We describe change in weight, midupper arm circumference (MUAC), arm muscle area (AMA) and arm fat area (AFA) in 1130 pregnant HIV-infected women with CD4 counts > 200 as part of the BAN Study ( www.thebanstudy.org ), a randomized, controlled clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast feeding. In a longitudinal analysis, we found a linear increase in weight with a mean rate of weight gain of 0.27 kgs/week, from baseline (12 to 30 weeks gestation) until the last follow-up visit (32–38 weeks). Analysis of weight gain showed that 17.1% of the intervals between visits resulted in a weight loss. In unadjusted models, MUAC and AMA increased and AFA declined during late pregnancy. Based on multivariable regression analysis, exposure to the famine season resulted in larger losses in AMA [−0.08, 95% CI −0.14, −0.02; p = 0.01] while AFA losses occurred irrespective of season [−0.55, 95%: −0.95, −0.14, p = 0.01]. CD4 was associated with AFA [0.21, 95% CI 0.01, 0.41, p = .04]. Age was positively associated with MUAC and AMA. Wealth was positively associated with MUAC, AFA, and weight. While patterns of anthropometric measures among HIV-infected, pregnant women were found to be similar to those reported for uninfected women in sub-Saharan Africa, effects of the famine season among undernourished, Malawian women are of concern. Strategies to optimize nutrition during pregnancy for these women appear warranted.

• Publisher: Springer US,Springer,Springer Nature B.V
• Subject: Acquired immune deficiency syndrome / Adult / African Continental Ancestry Group - statistics & numerical data / Age Distribution / AIDS / Analysis / Anthropometry / Antiretroviral agents / Arm / Body Composition / Body Mass Index / Breast feeding / Care and treatment / CD4 Lymphocyte Count / Child / Cross-Sectional Studies / Development and progression / Famine / Female / Gynecology / Health aspects / HIV / HIV infection / HIV Infections - complications / HIV Infections - virology / Human immunodeficiency virus / Humans / Malawi / Maternal and Child Health / Medicine / Medicine & Public Health / Muscle, Skeletal / Nutrition / Nutritional Status / Pediatrics / Population Economics / Pregnancy / Pregnancy Complications, Infectious - virology / Pregnant women / Public Health / Regression Analysis / Seasons / Skinfold Thickness / Socioeconomic Factors / Sociology / Starvation / Weight Gain / Womens health