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Published in: Maternal and Child Health Journal 2/2013

01-02-2013

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

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

Published in: Maternal and Child Health Journal | Issue 2/2013

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Abstract

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.
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Metadata
Title
Patterns of Body Composition Among HIV-Infected, Pregnant Malawians and the Effects of Famine Season
Authors
Roshan T. Ramlal
Martin Tembo
Alice Soko
Maggie Chigwenembe
Beth C. Tohill
Dumbani Kayira
Caroline C. King
Charles Chasela
Denise Jamieson
Charles van der Horst
Margaret E. Bentley
Linda S. Adair
the BAN Study Team
Publication date
01-02-2013
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 2/2013
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-012-0970-6

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