HIV-infected women susceptible to malnutrition during pregnancy, even with good antiretrovirol care

Malnutrition is common among HIV-infected pregnant women even when they receive antiretroviral therapy, leading to low birth weight and other health problems in their infants, according to a recent study conducted by a Cornell University faculty member working with the Makerere University-UCSF Research Collaboration.

In one of the few studies that have looked at the nutritional status of pregnant, HIV-infected women receiving antiretroviral therapy, about 15 percent of the women lost weight over the course of their pregnancies. Almost half of the women were anemic, a condition often caused by iron deficiency, according to lead researcher Sera Young, a research scientist in Cornell's Division of Nutritional Sciences.

"What we see is that even excellent clinical care on the best antiretroviral regimens that we have isn't sufficient for healthy pregnancies," said Young.

HIV is a "wasting disease," meaning that it depletes the body's muscle and fat stores. This combined with the increased nutritional needs of pregnancy make HIV-infected pregnant women particularly susceptible to malnutrition, Young said.

The researchers measured weight gain, iron status and other nutritional markers in 158 HIV-infected, pregnant Ugandan women receiving combination antiretroviral therapy. The study also followed the women throughout their pregnancies and found that the newborn infants also had poor health outcomes; about one-fifth of the babies had low birth weight, and preterm delivery and stunting were common.

"There's no better predictor of a child's health than the mother's health," said Young. "Working to keep the moms healthy to be able to care for these little babies is a pretty compelling reason for this research."

One of the positive findings of the study is that no mother transmitted HIV in utero or while giving birth to the babies, said Young.

Young is spearheading an ongoing study looking at the effects of nutritional supplementation in HIV-infected pregnant women, with the hope that augmenting their diet during pregnancy will improve both maternal and infant health outcomes.

Diane Havlir and Deborah Cohan, both researchers at the University of California-San Francisco, were the primary investigators. The study was part of PROMOTE, a larger clinical trial investigating malaria outcomes in HIV-infected pregnant women receiving antiretroviral therapy.

The results of this study were published in the Aug. 7 issue of the journal PLoS One.