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Pregnancy, body weight and human immunodeficiency virus infection in African women: A prospective cohort study in Kigali (Rwanda), 1992-1994

par Ladner, Joël;Castetbon, Katia ;Leroy, Valériane;Nyiraziraje, Marie;Chauliac, Michel;Karita, Etienne;De Clercq, Anne ;Van de Perre, Philippe ;Dabis, François
Référence International journal of epidemiology, 27, 6, page (1072-1077)
Publication Publié, 1998-12

Article révisé par les pairs

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Résumé :

Objective To study the relationship between human immunodeficiency virus (REV) infection and body weight in African women during and after pregnancy.Methods A prospective cohort study was initiated at the Centre Hospitalier de Kigali in July 1992. Every woman seen at the antenatal clinic and with a gestational age of <28 weeks was offered HIV-1 antibody testing. Comparable numbers of HIV-infected (HIV+) and uninfected (HIV−) women were recruited. At inclusion, socio-demographic characteristics and self-reported pre-pregnancy weight were recorded; height and weight were measured. Each woman enrolled had a monthly follow-up until 9 months after delivery, with a clinical examination including weighing. Three anthropometric indices were used to answer the study objectives: weight, body mass index (BMI), and pregnancy balance.Results As of April 1994, 101 HIV+ and 106 HIV− women were followed until 5 months after delivery. Weight and BMI during pregnancy were lower in HIV+ women than in HIV− women. After delivery, weight and BMI gains were significantly lower in HIV+ women. Until 5 months after delivery, the mean weight variation was −2.2 kg (standard deviation [SD] = 5.9 kg) in HIV+ women and +0.2 kg (SD = 6.6 kg) in HIV− women (P − 0.007) in comparison to pre-pregnancy weight. Comparisons of the slopes of the weight curves did not show statistical differences throughout the pregnancy, but it did during the post-partum period (P − 0.02).Conclusions Our study suggests that HIV infection could impair nutritional status in pregnant women, especially during the post-partum period. Family planning and maternal and child health services including HIV testing and counselling, should consider a nutritional assessment and intervention programme targeted to HIV+ pregnant women.