Skip to main content
Erschienen in: Maternal and Child Health Journal 2/2013

01.02.2013

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

verfasst von: Roshan T. Ramlal, Martin Tembo, Alice Soko, Maggie Chigwenembe, Beth C. Tohill, Dumbani Kayira, Caroline C. King, Charles Chasela, Denise Jamieson, Charles van der Horst, Margaret E. Bentley, Linda S. Adair, the BAN Study Team

Erschienen in: Maternal and Child Health Journal | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Grinspoon, S., Corcoran, C., Miller, K., Biller, B. M., Askari, H., Wang, E., et al. (1997). Body composition and endocrine function in women with acquired immunodeficiency syndrome wasting. Journal of Clinical Endocrinology and Metabolism, 82, 1332–1337.PubMedCrossRef Grinspoon, S., Corcoran, C., Miller, K., Biller, B. M., Askari, H., Wang, E., et al. (1997). Body composition and endocrine function in women with acquired immunodeficiency syndrome wasting. Journal of Clinical Endocrinology and Metabolism, 82, 1332–1337.PubMedCrossRef
2.
Zurück zum Zitat Grunfeld, C., Pang, M., Shimizu, L., Shigenaga, J. K., Jensen, P., & Feingold, K. R. (1992). Resting energy expenditure, caloric intake, and short-term weight change in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. American Journal of Clinical Nutrition, 55, 455–460.PubMed Grunfeld, C., Pang, M., Shimizu, L., Shigenaga, J. K., Jensen, P., & Feingold, K. R. (1992). Resting energy expenditure, caloric intake, and short-term weight change in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. American Journal of Clinical Nutrition, 55, 455–460.PubMed
3.
Zurück zum Zitat Villamor, E., Saathoff, E., Msamanga, G., O’Brien, M. E., Manji, K., & Fawzi, W. W. (2005). Wasting during pregnancy increases the risk of mother-to-child HIV-1 transmission. Journal of Acquired Immune Deficiency Syndromes, 38, 622–626.PubMedCrossRef Villamor, E., Saathoff, E., Msamanga, G., O’Brien, M. E., Manji, K., & Fawzi, W. W. (2005). Wasting during pregnancy increases the risk of mother-to-child HIV-1 transmission. Journal of Acquired Immune Deficiency Syndromes, 38, 622–626.PubMedCrossRef
4.
Zurück zum Zitat Friis, H., Gomo, E., Nyazema, N., Ndhlovu, P., Krarup, H., Kaestel, P., et al. (2004). Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe. British Journal of Nutrition, 92, 833–840.PubMedCrossRef Friis, H., Gomo, E., Nyazema, N., Ndhlovu, P., Krarup, H., Kaestel, P., et al. (2004). Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe. British Journal of Nutrition, 92, 833–840.PubMedCrossRef
5.
Zurück zum Zitat Tavris, D. R., & Read, J. A. (1982). Effect of maternal weight gain on fetal, infant, and childhood death and on cognitive development. Obstetrics and Gynecology, 60, 689–694.PubMed Tavris, D. R., & Read, J. A. (1982). Effect of maternal weight gain on fetal, infant, and childhood death and on cognitive development. Obstetrics and Gynecology, 60, 689–694.PubMed
6.
Zurück zum Zitat Stephansson, O., Dickman, P. W., Johansson, A. L., & Cnattingius, S. (2001). The influence of socioeconomic status on stillbirth risk in Sweden. International Journal of Epidemiology, 30, 1296–1301.PubMedCrossRef Stephansson, O., Dickman, P. W., Johansson, A. L., & Cnattingius, S. (2001). The influence of socioeconomic status on stillbirth risk in Sweden. International Journal of Epidemiology, 30, 1296–1301.PubMedCrossRef
7.
Zurück zum Zitat Stephansson, O., Dickman, P. W., Johansson, A., & Cnattingius, S. (2001). Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. American Journal of Obstetrics and Gynecology, 184, 463–469.PubMedCrossRef Stephansson, O., Dickman, P. W., Johansson, A., & Cnattingius, S. (2001). Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. American Journal of Obstetrics and Gynecology, 184, 463–469.PubMedCrossRef
8.
Zurück zum Zitat Kramer, M. S., Coates, A. L., Michoud, M. C., Dagenais, S., Hamilton, E. F., & Papageorgiou, A. (1995). Maternal anthropometry and idiopathic preterm labor. Obstetrics and Gynecology, 86, 744–748.PubMedCrossRef Kramer, M. S., Coates, A. L., Michoud, M. C., Dagenais, S., Hamilton, E. F., & Papageorgiou, A. (1995). Maternal anthropometry and idiopathic preterm labor. Obstetrics and Gynecology, 86, 744–748.PubMedCrossRef
9.
Zurück zum Zitat Chang, S. C., O’Brien, K. O., Nathanson, M. S., Mancini, J., & Witter, F. R. (2003). Characteristics and risk factors for adverse birth outcomes in pregnant black adolescents. Journal of Pediatrics, 143, 250–257.PubMedCrossRef Chang, S. C., O’Brien, K. O., Nathanson, M. S., Mancini, J., & Witter, F. R. (2003). Characteristics and risk factors for adverse birth outcomes in pregnant black adolescents. Journal of Pediatrics, 143, 250–257.PubMedCrossRef
10.
Zurück zum Zitat Schieve, L. A., Cogswell, M. E., Scanlon, K. S., Perry, G., Ferre, C., Blackmore-Prince, C., et al. (2000). Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery. The NMIHS Collaborative Study Group. Obstetrics and Gynecology, 96, 194–200.PubMedCrossRef Schieve, L. A., Cogswell, M. E., Scanlon, K. S., Perry, G., Ferre, C., Blackmore-Prince, C., et al. (2000). Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery. The NMIHS Collaborative Study Group. Obstetrics and Gynecology, 96, 194–200.PubMedCrossRef
11.
Zurück zum Zitat WHO. (1995). Maternal anthropometry and pregnancy outcomes. A WHO collaborative study. Bulletin of the World Health Organization, 73(suppl), 1–98. WHO. (1995). Maternal anthropometry and pregnancy outcomes. A WHO collaborative study. Bulletin of the World Health Organization, 73(suppl), 1–98.
12.
Zurück zum Zitat Strauss, R. S., & Dietz, W. H. (1999). Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation. Journal of Nutrition, 129, 988–993.PubMed Strauss, R. S., & Dietz, W. H. (1999). Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation. Journal of Nutrition, 129, 988–993.PubMed
13.
Zurück zum Zitat Taggart, N. R., Holiday, R. M., Billewics, W. Z., Hytten, F. E., & Thomason, A. M. (1967). Changes in skinfolds during pregnancy. British Journal of Nutrition, 21, 439–451.PubMedCrossRef Taggart, N. R., Holiday, R. M., Billewics, W. Z., Hytten, F. E., & Thomason, A. M. (1967). Changes in skinfolds during pregnancy. British Journal of Nutrition, 21, 439–451.PubMedCrossRef
14.
Zurück zum Zitat Hytten, F. (1980). Weight gain in pregnancy. In G. Chamberlain & F. E. Hytten (Eds.), Clinical physiology in obstetrics. Boston: Scientific Publications. Hytten, F. (1980). Weight gain in pregnancy. In G. Chamberlain & F. E. Hytten (Eds.), Clinical physiology in obstetrics. Boston: Scientific Publications.
15.
Zurück zum Zitat Pipe, N. G., Smith, T., Halliday, D., Edmonds, C. J., Williams, C., & Coltart, T. M. (1979). Changes in fat, fat-free mass and body water in human normal pregnancy. British Journal of Obstetrics and Gynaecology, 86, 929–940.PubMedCrossRef Pipe, N. G., Smith, T., Halliday, D., Edmonds, C. J., Williams, C., & Coltart, T. M. (1979). Changes in fat, fat-free mass and body water in human normal pregnancy. British Journal of Obstetrics and Gynaecology, 86, 929–940.PubMedCrossRef
16.
Zurück zum Zitat Ash, S., Fisher, C. C., Truswell, A. S., Allen, J. R., & Irwig, L. (1989). Maternal weight gain, smoking and other factors in pregnancy as predictors of infant birth-weight in Sydney women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 29, 212–219.PubMedCrossRef Ash, S., Fisher, C. C., Truswell, A. S., Allen, J. R., & Irwig, L. (1989). Maternal weight gain, smoking and other factors in pregnancy as predictors of infant birth-weight in Sydney women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 29, 212–219.PubMedCrossRef
17.
Zurück zum Zitat Villamor, E., Dreyfuss, M. L., Baylin, A., Msamanga, G., & Fawzi, W. W. (2004). Weight loss during pregnancy is associated with adverse pregnancy outcomes among HIV-1 infected women. Journal of Nutrition, 134, 1424–1431.PubMed Villamor, E., Dreyfuss, M. L., Baylin, A., Msamanga, G., & Fawzi, W. W. (2004). Weight loss during pregnancy is associated with adverse pregnancy outcomes among HIV-1 infected women. Journal of Nutrition, 134, 1424–1431.PubMed
18.
Zurück zum Zitat Friis, H., Gomo, E., Nyazema, N., Ndhlovu, P., Kaestel, P., Krarup, H., et al. (2002). HIV-1 viral load and elevated serum alpha(1)-antichymotrypsin are independent predictors of body composition in pregnant Zimbabwean women. Journal of Nutrition, 132, 3747–3753.PubMed Friis, H., Gomo, E., Nyazema, N., Ndhlovu, P., Kaestel, P., Krarup, H., et al. (2002). HIV-1 viral load and elevated serum alpha(1)-antichymotrypsin are independent predictors of body composition in pregnant Zimbabwean women. Journal of Nutrition, 132, 3747–3753.PubMed
19.
Zurück zum Zitat Prentice, A. M., Whitehead, R. G., Roberts, S. B., & Paul, A. A. (1981). Long-term energy balance in child-bearing Gambian women. American Journal of Clinical Nutrition, 34, 2790–2799.PubMed Prentice, A. M., Whitehead, R. G., Roberts, S. B., & Paul, A. A. (1981). Long-term energy balance in child-bearing Gambian women. American Journal of Clinical Nutrition, 34, 2790–2799.PubMed
20.
Zurück zum Zitat Bates, C. J., Prentice, A. M., & Paul, A. A. (1994). Seasonal variations in vitamins A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: Some possible implications. European Journal of Clinical Nutrition, 48, 660–668.PubMed Bates, C. J., Prentice, A. M., & Paul, A. A. (1994). Seasonal variations in vitamins A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: Some possible implications. European Journal of Clinical Nutrition, 48, 660–668.PubMed
21.
Zurück zum Zitat Branca, F., Pastore, G., Demissie, T., & Ferro-Luzzi, A. (1993). The nutritional impact of seasonality in children and adults of rural Ethiopia. European Journal of Clinical Nutrition, 47, 840–850.PubMed Branca, F., Pastore, G., Demissie, T., & Ferro-Luzzi, A. (1993). The nutritional impact of seasonality in children and adults of rural Ethiopia. European Journal of Clinical Nutrition, 47, 840–850.PubMed
23.
Zurück zum Zitat Prentice, A. M., Cole, T. J., Foord, F. A., Lamb, W. H., & Whitehead, R. G. (1987). Increased birthweight after prenatal dietary supplementation of rural African women. American Journal of Clinical Nutrition, 46, 912–925.PubMed Prentice, A. M., Cole, T. J., Foord, F. A., Lamb, W. H., & Whitehead, R. G. (1987). Increased birthweight after prenatal dietary supplementation of rural African women. American Journal of Clinical Nutrition, 46, 912–925.PubMed
24.
Zurück zum Zitat Ott, M., Fischer, H., Polat, H., Helm, E. B., Frenz, M., Caspary, W. F., et al. (1995). Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 9, 20–25.PubMed Ott, M., Fischer, H., Polat, H., Helm, E. B., Frenz, M., Caspary, W. F., et al. (1995). Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 9, 20–25.PubMed
25.
Zurück zum Zitat Suttmann, U., Ockenga, J., Selberg, O., Hoogestraat, L., Deicher, H., & Muller, M. J. (1995). Incidence and prognostic value of malnutrition and wasting in human immunodeficiency virus-infected outpatients. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 8, 239–246.PubMedCrossRef Suttmann, U., Ockenga, J., Selberg, O., Hoogestraat, L., Deicher, H., & Muller, M. J. (1995). Incidence and prognostic value of malnutrition and wasting in human immunodeficiency virus-infected outpatients. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 8, 239–246.PubMedCrossRef
26.
Zurück zum Zitat van der Horst, C., Chasela, C., Ahmed, Y., Hoffman, I., Hosseinipour, M., Knight, R., et al. (2009). Modifications of a large HIV prevention clinical trial to fit changing realities: a case study of the Breastfeeding, Antiretroviral, and Nutrition (BAN) protocol in Lilongwe, Malawi. Contemporary Clinical Trials, 30, 24–33.PubMedCrossRef van der Horst, C., Chasela, C., Ahmed, Y., Hoffman, I., Hosseinipour, M., Knight, R., et al. (2009). Modifications of a large HIV prevention clinical trial to fit changing realities: a case study of the Breastfeeding, Antiretroviral, and Nutrition (BAN) protocol in Lilongwe, Malawi. Contemporary Clinical Trials, 30, 24–33.PubMedCrossRef
27.
Zurück zum Zitat Moses, A., Zimba, C., Kamanga, E., Nkhoma, J., Maida, A., Martinson, F., et al. (2008). Prevention of mother-to-child transmission: program changes and the effect on uptake of the HIVNET 012 regimen in Malawi. AIDS, 22, 83–87.PubMedCrossRef Moses, A., Zimba, C., Kamanga, E., Nkhoma, J., Maida, A., Martinson, F., et al. (2008). Prevention of mother-to-child transmission: program changes and the effect on uptake of the HIVNET 012 regimen in Malawi. AIDS, 22, 83–87.PubMedCrossRef
28.
Zurück zum Zitat Hartikainen, H., Maleta, K., Kulmala, T., & Ashorn, P. (2005). Seasonality of gestational weight gain and fetal growth in rural Malawi. East African Medical Journal, 82, 294–299.PubMedCrossRef Hartikainen, H., Maleta, K., Kulmala, T., & Ashorn, P. (2005). Seasonality of gestational weight gain and fetal growth in rural Malawi. East African Medical Journal, 82, 294–299.PubMedCrossRef
29.
Zurück zum Zitat Rogerson, S. J., van den Broek, N. R., Chaluluka, E., Qongwane, C., Mhango, C. G., & Molyneux, M. E. (2000). Malaria and anemia in antenatal women in Blantyre, Malawi: a twelve-month survey. American Journal of Tropical Medicine and Hygiene, 62, 335–340.PubMed Rogerson, S. J., van den Broek, N. R., Chaluluka, E., Qongwane, C., Mhango, C. G., & Molyneux, M. E. (2000). Malaria and anemia in antenatal women in Blantyre, Malawi: a twelve-month survey. American Journal of Tropical Medicine and Hygiene, 62, 335–340.PubMed
30.
Zurück zum Zitat Kolenikov, S. A., & Angeles, G. (2004). The Use of Discrete Data in PCA: Theory, Simulations, and Applications to Socioeconomic Indices. Chapel Hill, NC: University of North Carolina at Chapel Hill and Carolina Population Center. Kolenikov, S. A., & Angeles, G. (2004). The Use of Discrete Data in PCA: Theory, Simulations, and Applications to Socioeconomic Indices. Chapel Hill, NC: University of North Carolina at Chapel Hill and Carolina Population Center.
31.
Zurück zum Zitat StataCorp. (2005). Stata statistical software: Release 9. College Station, TX: StataCorp LP. StataCorp. (2005). Stata statistical software: Release 9. College Station, TX: StataCorp LP.
32.
Zurück zum Zitat Eckhardt, C. L., Suchindran, C., Gordon-Larsen, P., & Adair, L. S. (2005). The association between diet and height in the postinfancy period changes with age and socioeconomic status in Filipino youths. Journal of Nutrition, 135, 2192–2198.PubMed Eckhardt, C. L., Suchindran, C., Gordon-Larsen, P., & Adair, L. S. (2005). The association between diet and height in the postinfancy period changes with age and socioeconomic status in Filipino youths. Journal of Nutrition, 135, 2192–2198.PubMed
33.
Zurück zum Zitat Harrell, F. E. (2001). Regression modeling strategies: with application to linear models, logistic regression and survival analysis. New York NY: Springer-Verlag New York. Harrell, F. E. (2001). Regression modeling strategies: with application to linear models, logistic regression and survival analysis. New York NY: Springer-Verlag New York.
34.
Zurück zum Zitat IOM. (1990). Nutrition during pregnancy—part I: Weight gain. Washington DC: National Academy Press. IOM. (1990). Nutrition during pregnancy—part I: Weight gain. Washington DC: National Academy Press.
35.
Zurück zum Zitat Moller, B., Gebre-Medhin, M., & Lindmark, G. (1989). Maternal weight, weight gain and birthweight at term in the rural Tanzanian village of Ilula. British Journal of Obstetrics and Gynaecology, 96, 158–166.PubMedCrossRef Moller, B., Gebre-Medhin, M., & Lindmark, G. (1989). Maternal weight, weight gain and birthweight at term in the rural Tanzanian village of Ilula. British Journal of Obstetrics and Gynaecology, 96, 158–166.PubMedCrossRef
36.
Zurück zum Zitat Neufeld, L., Pelletier, D. L., & Haas, J. D. (1999). The timing of maternal weight gain during pregnancy and fetal growth. American Journal of Human Biology, 11, 627–637.PubMedCrossRef Neufeld, L., Pelletier, D. L., & Haas, J. D. (1999). The timing of maternal weight gain during pregnancy and fetal growth. American Journal of Human Biology, 11, 627–637.PubMedCrossRef
37.
Zurück zum Zitat Villamor, E., Msamanga, G., Spiegelman, D., Peterson, K. E., Antelman, G., & Fawzi, W. W. (2003). Pattern and predictors of weight gain during pregnancy among HIV-1-infected women from Tanzania. Journal of Acquired Immune Deficiency Syndromes, 32, 560–569.PubMedCrossRef Villamor, E., Msamanga, G., Spiegelman, D., Peterson, K. E., Antelman, G., & Fawzi, W. W. (2003). Pattern and predictors of weight gain during pregnancy among HIV-1-infected women from Tanzania. Journal of Acquired Immune Deficiency Syndromes, 32, 560–569.PubMedCrossRef
38.
Zurück zum Zitat Hediger, M. L., Scholl, T. O., Schall, J. I., Healey, M. F., & Fischer, R. L. (1994). Changes in maternal upper arm fat stores are predictors of variation in infant birth weight. Journal of Nutrition, 124, 24–30.PubMed Hediger, M. L., Scholl, T. O., Schall, J. I., Healey, M. F., & Fischer, R. L. (1994). Changes in maternal upper arm fat stores are predictors of variation in infant birth weight. Journal of Nutrition, 124, 24–30.PubMed
39.
Zurück zum Zitat Kotler, D. P. (1998). Human immunodeficiency virus-related wasting: malabsorption syndromes. Seminars in Oncology, 25, 70–75.PubMed Kotler, D. P. (1998). Human immunodeficiency virus-related wasting: malabsorption syndromes. Seminars in Oncology, 25, 70–75.PubMed
40.
Zurück zum Zitat Poppitt, S. D., Prentice, A. M., Jequier, E., Schutz, Y., & Whitehead, R. G. (1993). Evidence of energy sparing in Gambian women during pregnancy: A longitudinal study using whole-body calorimetry. American Journal of Clinical Nutrition, 57, 353–364.PubMed Poppitt, S. D., Prentice, A. M., Jequier, E., Schutz, Y., & Whitehead, R. G. (1993). Evidence of energy sparing in Gambian women during pregnancy: A longitudinal study using whole-body calorimetry. American Journal of Clinical Nutrition, 57, 353–364.PubMed
41.
Zurück zum Zitat Macallan, D. C. (1999). Wasting in HIV infection and AIDS. Journal of Nutrition, 129, 238S–242S.PubMed Macallan, D. C. (1999). Wasting in HIV infection and AIDS. Journal of Nutrition, 129, 238S–242S.PubMed
42.
Zurück zum Zitat Castetbon, K., Ladner, J., Leroy, V., Chauliac, M., Karita, E., De Clercq, A., et al. (1999). Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy: Pregnancy and HIV Study Group (EGE). Journal of Tropical Pediatrics, 45, 152–157.PubMedCrossRef Castetbon, K., Ladner, J., Leroy, V., Chauliac, M., Karita, E., De Clercq, A., et al. (1999). Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy: Pregnancy and HIV Study Group (EGE). Journal of Tropical Pediatrics, 45, 152–157.PubMedCrossRef
43.
Zurück zum Zitat Ladner, J., Castetbon, K., Leroy, V., Nyiraziraje, M., Chauliac, M., Karita, E., et al. (1998). Pregnancy, body weight and human immunodeficiency virus infection in African women: A prospective cohort study in Kigali (Rwanda), 1992–1994. Pregnancy and HIV Study Group (EGE). International Journal of Epidemiology, 27, 1072–1077.PubMedCrossRef Ladner, J., Castetbon, K., Leroy, V., Nyiraziraje, M., Chauliac, M., Karita, E., et al. (1998). Pregnancy, body weight and human immunodeficiency virus infection in African women: A prospective cohort study in Kigali (Rwanda), 1992–1994. Pregnancy and HIV Study Group (EGE). International Journal of Epidemiology, 27, 1072–1077.PubMedCrossRef
44.
Zurück zum Zitat Kotler, D. P., Rosenbaum, K., Wang, J., & Pierson, R. N. (1999). Studies of body composition and fat distribution in HIV-infected and control subjects. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 20, 228–237.PubMedCrossRef Kotler, D. P., Rosenbaum, K., Wang, J., & Pierson, R. N. (1999). Studies of body composition and fat distribution in HIV-infected and control subjects. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 20, 228–237.PubMedCrossRef
45.
Zurück zum Zitat Villamor, E., Msamanga, G., Spiegelman, D., Coley, J., Hunter, D. J., Peterson, K. E., et al. (2002). HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy. European Journal of Clinical Nutrition, 56, 415–424.PubMedCrossRef Villamor, E., Msamanga, G., Spiegelman, D., Coley, J., Hunter, D. J., Peterson, K. E., et al. (2002). HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy. European Journal of Clinical Nutrition, 56, 415–424.PubMedCrossRef
Metadaten
Titel
Patterns of Body Composition Among HIV-Infected, Pregnant Malawians and the Effects of Famine Season
verfasst von
Roshan T. Ramlal
Martin Tembo
Alice Soko
Maggie Chigwenembe
Beth C. Tohill
Dumbani Kayira
Caroline C. King
Charles Chasela
Denise Jamieson
Charles van der Horst
Margaret E. Bentley
Linda S. Adair
the BAN Study Team
Publikationsdatum
01.02.2013
Verlag
Springer US
Erschienen in
Maternal and Child Health Journal / Ausgabe 2/2013
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-012-0970-6

Weitere Artikel der Ausgabe 2/2013

Maternal and Child Health Journal 2/2013 Zur Ausgabe