Maternal weight and birth outcomes among women on antiretroviral treatment from conception in a birth surveillance study in Botswana

Abstract Background Women with vertically acquired HIV (VHIV) may have a greater risk of adverse birth outcomes than women with horizontally acquired HIV (HHIV). Methods The Tsepamo study performed birth outcomes surveillance at 8 government delivery sites in Botswana from July 2014 through March 2019. Pregnant women diagnosed with HIV before their 11th birthday received VHIV status, and other women had HHIV. Small for gestational age (SGA), preterm delivery (PTD), stillbirth, and neonatal death were compared using χ2 and Fisher’s exact tests. Log-binomial regression models determined risk ratios (RRs). Results VHIV women (n = 402) aged 15–27 years were identified over 4 years of surveillance and compared with HHIV women (n = 8465) of the same age. VHIV women were more likely to use nevirapine (NVP)-based antiretroviral treatment (ART) in pregnancy and to have SGA and very SGA infants, but less likely to have very PTD infants. In unadjusted analyses, VHIV women had a higher risk of any adverse birth outcome combined (RR = 1.21, 95% confidence interval [CI], 1.08–1.36). After adjusting for potential confounders, particularly use of NVP-based regimens, the risk of adverse birth outcomes among VHIV and HHIV women was similar. Conclusions NVP-based ART is a primary and modifiable risk factor for adverse birth outcomes. Updating ART regimens could improve birth outcomes for women with HIV.

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Association of leptin receptor expression in placenta and peripheral blood mononuclear cell with maternal weight in birth outcomes

Cytokine ◽

10.1016/j.cyto.2020.155362 ◽

2021 ◽

Vol 138 ◽

pp. 155362

Author(s):

M.A. Galindo-Cáceres ◽

R. Parra-Unda ◽

J. Murillo-Llanes ◽

F. Morgan-Ortiz ◽

J.G. Rendón-Maldonado ◽

...

Keyword(s):

Peripheral Blood Mononuclear Cell ◽

Mononuclear Cell ◽

Birth Outcomes ◽

Peripheral Blood ◽

Leptin Receptor ◽

Receptor Expression ◽

Maternal Weight ◽

Peripheral Blood Mononuclear

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Relations between neighbourhood socioeconomic status and birth outcomes are mediated by maternal weight

Social Science & Medicine ◽

10.1016/j.socscimed.2016.12.041 ◽

2017 ◽

Vol 175 ◽

pp. 143-151 ◽

Cited By ~ 11

Author(s):

Zahra M. Clayborne ◽

Gerald F. Giesbrecht ◽

Rhonda C. Bell ◽

Lianne M. Tomfohr-Madsen

Keyword(s):

Socioeconomic Status ◽

Birth Outcomes ◽

Maternal Weight ◽

Neighbourhood Socioeconomic Status

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Sistematic Review: Relationship between Pregnant Women Weight, Fetal Weight, Age at Pregnancy, Gravida Status with Birth Weight

Jurnal Delima Harapan ◽

10.31935/delima.v7i1.91 ◽

2020 ◽

Vol 7 (1) ◽

pp. 19-23

Author(s):

Liliek Pratiwi

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Nutritional Status ◽

Pregnant Women ◽

Birth Outcomes ◽

Fetal Weight ◽

Biological Factors ◽

Maternal Weight ◽

Older Mothers ◽

The Relationship

Background : A person's nutritional condition is influenced by her nutritional status during the womb. In other words, the nutritional status of pregnant women is very influential on their own health and as a predictor of pregnancy outcomes for mothers and nutritional status of newborns (Senbanjo et al, 2013). This is due to fetal food intake can be through the umbilical cord that is connected to the mother's body (Indreswari et al, 2008). Various maternal and child health efforts are carried out to reduce mortality. One of them is obstructed fetal growth which must be known while still in utero so that the clinician can be more stringent in monitoring and planning the delivery method to reduce the risk of perinatal death. The increase in maternal weight during pregnancy is directly related to the weight of the baby and the risk of giving birth to low birth weight increases with a lack of weight gain during pregnancy. This shows a significant relationship between the increase in body weight of pregnant women and the weight of the baby born. (handayani, 2013). From several studies, it is still not known what factors most influence the birth weight of the baby, so in this study sistematic review was carried out as a strong first step for other researchers in developing this research. Method : A systematic review through journal reviews of the relationship between maternal weight, fetal weight, age at pregnancy, status of Gravida with birth weight Result and Discussion : Based on the analysis of the article it was found that the relationship between maternal weight, fetal weight, gestational age, gravida status and birth weight. Several studies have reported an increased risk of low birth weight (LBW) among offspring (generally defined as women <20 years). The number of births for women 35 years and over is increasing in both high-income countries and middle-income countries. Several mechanisms have been suggested to explain this. Biological mechanisms for increasing infant birth Low birth weight (LBW) in teenage mothers <20 years can be explained as follows. Blood circulation to the cervix and also to the uterus in adolescents is still not perfect so this can interfere with the process of channeling nutrients from the mother to the fetus she contains. Nutrition of pregnant adolescents also plays a role because adolescents still need nutrients to be shared with the fetus they contain compared to adult pregnant women who do not need nutrients for growth (Johanes, 2009 in Rahardjo et al, 2011). Teenage mothers are inherently at risk for birth outcomes that are compromised because biological factors are considered. A large US sample shows that unfavorable birth outcomes for adolescent mothers compared to older mothers occur at several levels due to biological factors (Fraser, Brockert, & Ward, 1995; Chen, et al., 2007). However, additional research shows that this difference does not exist among African-American women because of higher average exposure to social and environmental losses compared to whites (Geronimus, 1987; 1996). This explanation shows that unfavorable birth outcomes among teens compared to older mothers are the norm, from which African American mothers deviate as a result of lower socioeconomic status (SES). The role of social loss in understanding the risks of compromised young mothers from birth outcomes is examined, especially those related to the selection of disadvantaged teenagers to give birth to children. Thus, the way the age of young mothers is associated with unfavorable birth outcomes is considered, both cross and in racial / ethnic groups Conclusion : This study has not been able to find a relationship between the weight gain of pregnant women on the weight of the baby born. According to assumptions, this happens because there are still other factors that are not yet known exactly where these factors can affect the weight of the baby born.

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The London Exercise And Pregnant smokers (LEAP) trial: a randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation

Health Technology Assessment ◽

10.3310/hta19840 ◽

2015 ◽

Vol 19 (84) ◽

pp. 1-136 ◽

Cited By ~ 14

Author(s):

Michael Ussher ◽

Sarah Lewis ◽

Paul Aveyard ◽

Isaac Manyonda ◽

Robert West ◽

...

Keyword(s):

Smoking Cessation ◽

Economic Evaluation ◽

Birth Outcomes ◽

Controlled Trial ◽

Control Group ◽

Maternal Weight ◽

Smoking During Pregnancy ◽

Behavioural Support ◽

Significant Difference ◽

Randomised Controlled

BackgroundSmoking during pregnancy is the main preventable cause of poor birth outcomes. Improved methods are needed to help women to stop smoking during pregnancy. Pregnancy provides a compelling rationale for physical activity (PA) interventions as cessation medication is contraindicated or ineffective, and an effective PA intervention could be highly cost-effective.ObjectiveTo examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy.DesignMulticentre, two-group, pragmatic randomised controlled trial and economic evaluation with follow-up at the end of pregnancy and 6 months postnatally. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio.Setting13 hospitals offering antenatal care in the UK.ParticipantsWomen between 10 and 24 weeks’ gestation smoking five or more cigarettes a day before pregnancy and one or more during pregnancy.InterventionsParticipants were randomised to behavioural support for smoking cessation (control) or behavioural support plus a PA intervention consisting of supervised treadmill exercise plus PA consultations. Neither participants nor researchers were blinded to treatment allocation.Main outcome measuresThe primary outcome was self-reported, continuous smoking abstinence between a quit date and end of pregnancy, validated by expired carbon monoxide and/or salivary cotinine. Secondary outcomes were maternal weight, depression, birth outcomes, withdrawal symptoms and urges to smoke. The economic evaluation investigated the costs of the PA intervention compared with the control intervention.ResultsIn total, 789 women were randomised (n = 394 PA,n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA,n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%;p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate.ConclusionsDuring pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence.Trial registrationCurrent Controlled Trials ISRCTN48600346.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 84. See the NIHR Journals Library website for further project information.

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Seasonality of adverse birth outcomes in women with and without HIV in a representative birth outcomes surveillance study in Botswana

BMJ Open ◽

10.1136/bmjopen-2020-045882 ◽

2021 ◽

Vol 11 (9) ◽

pp. e045882

Author(s):

Ellen C Caniglia ◽

Jasmyn Abrams ◽

Modiegi Diseko ◽

Gloria Mayondi ◽

Judith Mabuta ◽

...

Keyword(s):

Climate Change ◽

Preterm Delivery ◽

Birth Outcomes ◽

Birth Outcome ◽

Dry Season ◽

Surveillance Study ◽

Adverse Birth Outcomes ◽

Hiv Status ◽

Wet Season ◽

Very Preterm

IntroductionSub-Saharan Africa has the largest number of people with HIV, one of the most severe burdens of adverse birth outcomes globally and particular vulnerability to climate change. We examined associations between seasonality and adverse birth outcomes among women with and without HIV in a large geographically representative birth outcomes surveillance study in Botswana from 2015 to 2018.MethodsWe evaluated stillbirth, preterm delivery, very preterm delivery, small for gestational age (SGA), very SGA, and combined endpoints of any adverse or severe birth outcome. We estimated the risk of each outcome by month and year of delivery, and adjusted risks ratios (ARRs) of outcomes during the early wet (1 November–15 January), late wet (16 January–31 March) and early dry (1 April–15 July) seasons, compared with the late dry (16 July–31 October) season. Analyses were conducted overall and separately by HIV status.ResultsAmong 73 178 women (24% with HIV), the risk of all adverse birth outcomes peaked in November–January and reached low points in September. Compared with the late dry season, the ARRs for any adverse birth outcome were 1.03 (95% CI 1.00 to 1.06) for the early dry season, 1.08 (95% CI 1.04 to 1.11) for the early wet season and 1.07 (95% CI 1.03 to 1.10) for the late wet season. Comparing the early wet season to the late dry season, we found that ARRs for stillbirth and very preterm delivery were higher in women with HIV (1.23, 95% CI 0.96 to 1.59, and 1.33, 95% CI 1.10 to 1.62, respectively) than in women without HIV (1.07, 95% CI 0.91 to 1.26, and 1.19, 95% CI 1.04 to 1.36, respectively).ConclusionsWe identified a modest association between seasonality and adverse birth outcomes in Botswana, which was greatest among women with HIV. Understanding seasonal patterns of adverse birth outcomes and the role of HIV status may allow for mitigation of their impact in the face of seasonal extremes related to climate change.

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