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© 1998 Oxford University Press
research-article |
Pregnancy, body weight and human immunodeficiency virus infection in African women: a prospective cohort study in Kigali (Rwanda), 1992–1994
aMedical Information Unit, Centre Hospitalier de Kigali (CHK) Kigali, Rwanda
bINSERM U. 330, Université Victor Segalen Bordeaux 2 Bordeaux, France
cORSTOM Petit Bassam Abidjan, Cöte d'Ivoire
dDepartment of Gynaecology and Obstetrics CHK
eCentre International de l'Enfance et de la Famille Paris, France
fAIDS Reference Laboratory, National AIDS Control Programme Kigali, Rwanda
Reprint requests to: Dr Joël Ladner, Mission Française de Coopération, 01 BP 1839 Abidjan 01, Côte d'Ivoire
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.
Keywords HIV-1, pregnancy, body weight, Africa
Accepted 6 April 1998
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