Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-15T07:30:22.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe

Published online by Cambridge University Press:  09 March 2007

Henrik Friis ,
Exnevia Gomo ,
Norman Nyazema ,
Patricia Ndhlovu ,
Henrik Krarup ,
Pernille Kæstel  and
Kim Fleischer Michaelsen
Henrik Friis*
Affiliation:
Department of Epidemiology, Institute of Public Health, University of Copenhagen, Panum Institute, Blegdamsvej 3, DK-2200, Copenhagen, N, Denmark
Exnevia Gomo
Affiliation:
Blair Research Laboratory, Ministry of Health, Harare, Zimbabwe Department of Immunology, University of Zimbabwe, Harare, Zimbabwe
Norman Nyazema
Affiliation:
Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe
Patricia Ndhlovu
Affiliation:
Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe
Henrik Krarup
Affiliation:
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Pernille Kæstel
Affiliation:
Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark
Kim Fleischer Michaelsen
Affiliation:
Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark
*
*Corresponding author: Associate Professor Henrik Friis, fax +45 35 32 73 83, email, [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd–35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66·3%) women, of which 360 (32·5%) had HIV infection. Mean gestation length was 39·1 weeks with 16·6% <37 weeks, mean birth weight was 3030 g with 10·5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0·005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.

Keywords

PregnancyHIV infectionBody compositionGestation lengthBirth sizeZimbabwe
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 5 , November 2004 , pp. 833 - 840
Copyright
Copyright © The Nutrition Society 2004

References

Ashworth, A (1998) Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. Eur J Clin Nutr 52 Suppl. 1S34–S41.Google ScholarPubMed
Ayisi, JG, van Eijk AM, ter, Kuile, FO, Kolczak, MS, Otieno, JA, Misore, AO, Kager, PA, Steketee, RW & Nahlen, BL (2003) The effect of dual infection with HIV and malaria on pregnancy outcome in western Kenya. AIDS 17, 585–594.CrossRefGoogle ScholarPubMed
Barker, DJ, Forsen, T, Uutela, A, Osmond, C & Eriksson, JG (2001) Size at birth and resilience to effects of poor living conditions in adult life: longitudinal study. BMJ 323, 1273–1276.CrossRefGoogle ScholarPubMed
Castetbon, K, Ladner, J, Leroy, V, Chauliac, M, Karita, E, De Clercq, A, Van de Perre, P & Dabis, F (1999) Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy: Pregnancy and HIV Study Group (EGE). J Trop Pediatr 45, 152–157.CrossRefGoogle Scholar
de Onis, M, Blossner, M & Villar, J (1998) Levels and patterns of intrauterine growth retardation in developing countries. Eur J Clin Nutr 52 Suppl. 1S5–S15.Google ScholarPubMed
Dreyfuss, ML, Msamanga, GI, Spiegelman, D, Hunter, DJ, Urassa, EJ, Hertzmark, E & Fawzi, WW (2001) Determinants of low birth weight among HIV-infected pregnant women in Tanzania. Am J Clin Nutr 74, 814–826.CrossRefGoogle ScholarPubMed
Friis, H, Gomo, E, Kaestel, P, Nyazema, N, Ndhlovu, P & Michaelsen, KF (2002 a) Does the first pregnancy precipitate age-related fat deposition?. Int J Obes 26, 1274–1276.CrossRefGoogle ScholarPubMed
Friis, H, Gomo, E, Koestel, P, Ndhlovu, P, Nyazema, N, Krarup, H & Michaelsen, KF (2001 a) HIV and other predictors of serum beta-carotene and retinol in pregnancy: a cross-sectional study in Zimbabwe. Am J Clin Nutr 73, 1058–1065.CrossRefGoogle ScholarPubMed
Friis, H, Gomo, E, Koestel, P, Ndhlovu, P, Nyazema, N, Krarup, H & Michaelsen, KF (2001 b) HIV and other predictors of serum folate, serum ferritin, and hemoglobin in pregnancy: a cross-sectional study in Zimbabwe. Am J Clin Nutr 73, 1066–1073.CrossRefGoogle ScholarPubMed
Friis, H, Gomo, E, Nyazema, N, Ndhlovu, P, Kaestel, P, Krarup, H & Michaelsen, KF (2002 b) HIV-1 viral load and elevated serum alpha(1)-antichymotrypsin are independent predictors of body composition in pregnant Zimbabwean women. J Nutr 132, 3747–3753.CrossRefGoogle ScholarPubMed
Friis, H, Gomo, E, Nyazema, N, Ndhlovu, P, Krarup, H, Kaestel, P & Michaelsen, KF (2004) Effects of multimicronutrient supplementation on gestation length and birth size: a randomized, placebo-controlled, double-blind effectiveness trial in Zimbabwe. Am J Clin Nutr 80, 178–184.CrossRefGoogle Scholar
Friis, H, Gomo, E, Nyazema, N, Ndhlovu, P, Krarup, H & Madsen, PH (2003) Fe, haptoglobin phenotype and HIV-1 viral load: a cross-sectional study among pregnant Zimbabwean women. J Acquir Immune Defic Syndr 33, 74–81.CrossRefGoogle Scholar
Glynn, JR, Buve, A, Carael, M, Kahindo, M, Macauley, IB, Musonda, RM, Jungmann, E, Tembo, F & Zekeng, L (2000) Decreased fertility among HIV-1-infected women attending antenatal clinics in three African cities. J Acquir Immune Defic Syndr 25, 345–352.CrossRefGoogle ScholarPubMed
Gray, RH, Wawer, MJ & Serwadda, D (1998) Population-based study of fertility in women with HIV-1 infection in Uganda. Lancet 351, 98–103.CrossRefGoogle ScholarPubMed
Hediger, ML, Scholl, TO, Schall, JI, Healey, MF & Fischer, RL (1994) Changes in maternal upper arm fat stores are predictors of variation in infant birth weight. J Nutr 124, 24–30.CrossRefGoogle ScholarPubMed
Institute of MedicineInstitute of Medicine (1990) Body composition changes during pregnancy Nutrition During Pregnancy, 121–136Washington, DC: National Academy Press..Google Scholar
Kramer, MS (2003) The epidemiology of adverse pregnancy outcomes: an overview. J Nutr 133, 1592S–1596S.CrossRefGoogle ScholarPubMed
Krarup, HB, Drewes, AM & Madsen, PH (1998) A quantitative HCV-PCR test for routine diagnostics. Scand J Clin Lab Invest 58, 415–422.CrossRefGoogle ScholarPubMed
Langhoff-Roos, J, Lindmark, G, Gebre-Medhin, M (1987) Maternal fat stores and fat accretion during pregnancy in relation to infant birthweight. Br J Obstet Gynaecol 94, 1170–1177.CrossRefGoogle ScholarPubMed
Lumey, LH (1998) Reproductive outcomes in women prenatally exposed to undernutrition: a review of findings from the Dutch famine birth cohort. Proc Nutr Soc 57, 129–135.CrossRefGoogle ScholarPubMed
McDade, TW, Beck, MA, Kuzawa, C & Adair, LS (2001) Prenatal undernutrition, postnatal environments, and antibody response to vaccination in adolescence. Am J Clin Nutr 74, 543–548.CrossRefGoogle ScholarPubMed
Moore, SE, Cole, TJ, Collinson, AC, Poskitt, EM, McGregor, IA & Prentice, AM (1999) Prenatal or early postnatal events predict infectious deaths in young adulthood in rural Africa. Int J Epidemiol 28, 1088–1095.CrossRefGoogle ScholarPubMed
Neggers, Y & Goldenberg, RL (2003) Some thoughts on body mass index, micronutrient intakes and pregnancy outcome. J Nutr 133, 1737S–1740S.CrossRefGoogle ScholarPubMed
Neggers, Y, Goldenberg, RL, Cliver, SP, Hoffman, HJ & Cutter, GR (1992) Usefulness of various maternal skinfold measurements for predicting newborn birth weight. J Am Diet Assoc 92, 1393–1394.CrossRefGoogle ScholarPubMed
Norgan, NG (1997) The beneficial effects of body fat and adipose tissue in humans. Int J Obes Relat Metab Disord 21, 738–746.CrossRefGoogle ScholarPubMed
O'Shea, S, Newell, ML & Dunn, DT (1998) Maternal viral load, CD4 cell count and vertical transmission of HIV-1. J Med Virol 54, 113–117.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Prentice, AM, Cole, TJ, Foord, FA, Lamb, WH & Whitehead, RG (1987) Increased birthweight after prenatal dietary supplementation of rural African women. Am J Clin Nutr 46, 912–925.CrossRefGoogle ScholarPubMed
Rao, S, Yajnik, CS & Kanade, A (2001) Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune Maternal Nutrition Study. J Nutr 131, 1217–1224.CrossRefGoogle ScholarPubMed
Steketee, RW (2003) Pregnancy, nutrition and parasitic diseases. J Nutr 133, 1661S–1667S.CrossRefGoogle ScholarPubMed
Zaadstra, BM, Seidell, JC, van Noord, PA, te, Velde, ER, Habbema, JD, Vrieswijk & Karbaat, J (1993) Fat and female fecundity: prospective study of effect of body fat distribution on conception rates. BMJ 306, 484–487.CrossRefGoogle ScholarPubMed