Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1102, Boston, MA, 02115, USA.
Division of Gastroenterology and Nutrition, Children's Hospital Boston, Boston, MA, USA.
BMC Pregnancy Childbirth. 2018 Dec 17;18(1):500. doi: 10.1186/s12884-018-2136-z.
An observational study was conducted to examine the role of maternal anthropometry, including mid-arm muscle area (MAMA) and others, as risk factors for low birth weight (LBW), small for gestational age (SGA) and preterm births in human immunodeficiency virus (HIV) infected pregnant women. HIV-positive women (N = 2369), between 12 and 32 weeks gestation were followed through delivery in Tanzania, from 2003 to 2008. Participants were women enrolled in a randomized, double-blind, placebo-controlled, clinical trial who delivered live births.
Binomial regression analysis was used to evaluate the association of maternal nutritional indicators of MAMA, mid-upper arm circumference (MUAC), body mass index (BMI) and maternal weight with LBW, SGA and preterm in multivariate analysis.
Higher MAMA was associated with a 32% lower risk of LBW compared to lower measurements (RR = 0.68, 95% CI = 0.50-0.94). Similar protective associations were noted for higher BMI (RR = 0.58, 95% CI = 0.42-0.79); maternal weight (RR = 0.50, 95% CI = 0.36-0.69) and MUAC (RR = 0.62, 95% CI = 0.45-0.86). Higher MAMA was also associated with lower risk of SGA (RR = 0.78, 95% CI = 0.68-0.90) and marginally associated with preterm (RR = 0.85, 95% CI = 0.69-1.04). Beneficial associations of MUAC, BMI and maternal weight with SGA and preterm were also observed.
MAMA performs comparably to MUAC, maternal weight and BMI, as a predictor of LBW and SGA in HIV-infected women. The possible role of MAMA and other indicators in screening HIV positive women at risk of adverse pregnancy outcomes should be investigated.
本观察性研究旨在探讨母体人体测量学指标（包括上臂中部肌肉面积[MAMA]等）作为人免疫缺陷病毒（HIV）感染孕妇低出生体重（LBW）、小于胎龄儿（SGA）和早产风险因素的作用。2003 年至 2008 年期间，在坦桑尼亚，对 2369 名妊娠 12 至 32 周的 HIV 阳性孕妇进行了随访直至分娩。这些参与者是参加一项随机、双盲、安慰剂对照、临床试验并分娩活产儿的孕妇。
采用二项回归分析评估 MAMA、中上臂围（MUAC）、体重指数（BMI）和母体体重等母体营养指标与 LBW、SGA 和早产的多变量分析中的关联。
与较低的测量值相比，较高的 MAMA 与 LBW 的风险降低 32%相关（RR=0.68，95%CI=0.50-0.94）。类似的保护关联也见于较高的 BMI（RR=0.58，95%CI=0.42-0.79）、母体体重（RR=0.50，95%CI=0.36-0.69）和 MUAC（RR=0.62，95%CI=0.45-0.86）。较高的 MAMA 也与 SGA 的风险降低相关（RR=0.78，95%CI=0.68-0.90），与早产呈边缘相关（RR=0.85，95%CI=0.69-1.04）。MUAC、BMI 和母体体重与 SGA 和早产的有益关联也得到了观察。
MAMA 与 MUAC、母体体重和 BMI 一样，可作为预测 HIV 感染妇女 LBW 和 SGA 的指标。应研究 MAMA 和其他指标在筛查有不良妊娠结局风险的 HIV 阳性妇女中的作用。
