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

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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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Acknowledgments

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This analysis was funded by National Institutes of Health R03 grant R03HD057637.

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Authors and Affiliations

  1. University of North Carolina, Chapel Hill, NC, USA

    Roshan T. Ramlal, Charles van der Horst, Margaret E. Bentley & Linda S. Adair

  2. UNC Project, Lilongwe, Malawi

    Martin Tembo, Alice Soko, Maggie Chigwenembe, Dumbani Kayira & Charles Chasela

  3. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Beth C. Tohill, Caroline C. King & Denise Jamieson

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  1. Roshan T. Ramlal
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Correspondence to Roshan T. Ramlal.

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Ramlal, R.T., Tembo, M., Soko, A. et al. Patterns of Body Composition Among HIV-Infected, Pregnant Malawians and the Effects of Famine Season. Matern Child Health J 17, 265–273 (2013). https://doi.org/10.1007/s10995-012-0970-6

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