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HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy

European Journal of Clinical Nutrition volume 56, pages 415–424 (2002)Cite this article

Abstract

Objective: To examine HIV status and sociodemographic variables as correlates of body size (height, body mass index (BMI), and mid-upper-arm circumference (MUAC)) and wasting (MUAC <22 cm) in pregnant women.

Design: Cross-sectional study.

Setting: Four antenatal clinics in Dar es Salaam, Tanzania.

Subjects: Women presenting for first prenatal visit before the 23rd week of gestation, between April 1995 and July 1997 (n=13 760).

Results: Mean MUAC, BMI and height were 25.5 cm, 23.5 kg/m2 and 155.1 cm, respectively. The prevalence of HIV infection was 13.1% and the overall prevalence of wasting was 4.7%. Wasting was 34% (95% CI=3%, 73%) more prevalent among HIV-infected than in uninfected mothers, after adjusting for week of gestation, height and sociodemographic indicators. The risk of wasting associated with HIV infection was highest among women with low level of education or unable to contribute to the household income. From a multiple linear regression model, BMI was positively associated with mother's age, level of education and money spent on food, but not with HIV infection, after adjusting for week of gestation. In multivariate analysis, height increased monotonically by categories of maternal age and level of education, and was also positively correlated with the ability to contribute to household income, the amount of money spent on food per person per day, and having a professional partner.

Conclusion: HIV infection is a significant risk factor for wasting among pregnant women, particularly in groups of low socioeconomic status (SES). SES indicators are strongly correlated with maternal height and with BMI during the first and second trimesters of pregnancy independently of HIV status.

Sponsorship: The National Institute of Child Health and Human Development (NICHD R01 32257), and the Fogarty International Center (NIH D43 TW00004).

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Acknowledgements

We wish to thank the women who participated in this project, the study coordinator, Mrs Illuminata Ballonzi; study physicians, Dr Heavington Mshiu, Dr Vencesla Sequera; research assistants, laboratory technicians, nurses, midwives and administrative staff who made the study possible. We are grateful to Ellen Hertzmark for assistance in computer programming. The Fulbright program, the Colombian Institute for the Development of Science and Technology ‘Colciencias’, and the National University of Colombia provided partial support to Eduardo Villamor. This study was sponsored by the National Institute of Child Health and Human Development (grant NICHD R01 32257), and the Fogarty International Center (grant NIH D43 TW00004).

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Author notes

  1. E Villamor: Guarantor: E Villamor.

  2. E Villamor, G Msamanga, D Spiegelman, J Coley, DJ Hunter, KE Peterson and WW Fawzi: Contributors: EV analyzed and interpreted the data and wrote the initial draft of the manuscript. WWF and GM are principal investigators of the Tanzania Vitamin Supplementation Trial and contributed to the study design and its implementation. DS provided statistical guidance in data analyses. JC contributed to study implementation in the field. KP assisted in data interpretation. All coauthors participated in manuscript preparation.

Authors and Affiliations

  1. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA

    E Villamor, J Coley, DJ Hunter, KE Peterson & WW Fawzi

  2. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

    E Villamor, D Spiegelman, DJ Hunter & WW Fawzi

  3. Departments of Community Health and Obstetrics and Gynecology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania

    G Msamanga

  4. Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA

    D Spiegelman

  5. Department of Maternal and Child Health, Harvard School of Public Health, Boston, Massachusetts, USA

    KE Peterson

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Correspondence to E Villamor.

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Villamor, E., Msamanga, G., Spiegelman, D. et al. HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy. Eur J Clin Nutr 56, 415–424 (2002). https://doi.org/10.1038/sj.ejcn.1601328

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