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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*
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]
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Abstract

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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.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2004

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