Maternal mid‐upper arm circumference (MUAC) is associated with lower birth weight among HIV‐exposed but not unexposed infants in a peri‐urban antenatal clinic in northwestern Tanzania

Abstract

Women in rural and semi‐urban areas of Africa face additional healthcare access barriers affecting birth outcomes and HIV‐exposed infants have a poorer prognosis compared to unexposed infants. Our objective was to characterize associations between maternal nutritional status during pregnancy and birth outcomes of HIV+ and HIV− women enrolled in a semi‐urban antenatal clinic cohort in northwestern Tanzania. Of the 46 HIV+ and 72 HIV−women enrolled, 21 HIV+ and 36 HIV− women delivered at/returned to clinic within 48 hours and were included in the analysis. Maternal anthropometrics were assessed at 20–36 weeks gestation, and HIV+ women were receiving antiretroviral therapy by delivery. Twenty nine percent of HIV+ and 22% of HIV−women had evidence of malnutrition (MUAC <25cm), but neither MUAC nor tricep skinfold (TSF) thickness differed by HIV status. HIV‐exposed neonates had lower birth weight and length compared with unexposed infants. Despite similarities in maternal anthropometrics, maternal MUAC and TSF predicted infant birth weight only in HIV‐exposed infants. Findings suggest that in HIV+ pregnant women living in rural or semi‐urban areas, maternal nutritional status based upon simple‐to‐measure anthropometry is an important determinant of infant anthropometrics among HIV‐exposed infants, and maternal MUAC identifies HIV+ women at higher risk of delivering low birth weight infants in this setting.Grant Funding Source: Cornell University Unrestricted Grant