Perinatal Outcomes, Including Mother‐to‐Child Transmission of HIV, and Child Mortality and Their Association with Maternal Vitamin D Status in Tanzania

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Perinatal Outcomes, Including Mother‐to‐Child Transmission of HIV, and Child Mortality and Their Association with Maternal Vitamin D Status in Tanzania

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Title: Perinatal Outcomes, Including Mother‐to‐Child Transmission of HIV, and Child Mortality and Their Association with Maternal Vitamin D Status in Tanzania
Author: Mehta, Saurabh; Hunter, David J.; Mugusi, Ferdinand M.; Spiegelman, Donna Lynn; Manji, Karim P.; Giovannucci, Edward L.; Hertzmark, Ellen; Msamanga, Gernard I.; Fawzi, Wafaie W.

Note: Order does not necessarily reflect citation order of authors.

Citation: Mehta, Saurabh, David J. Hunter, Ferdinand M. Mugusi, Donna Spiegelman, Karim P. Manji, Edward L. Giovannucci, Ellen Hertzmark, Gernard I. Msamanga, and Wafaie W. Fawzi. 2009. “Perinatal Outcomes, Including Mother‐to‐Child Transmission of HIV, and Child Mortality and Their Association with Maternal Vitamin D Status in Tanzania.” J INFECT DIS 200 (7) (October): 1022–1030. doi:10.1086/605699.
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Abstract: Background

Vitamin D is a strong immunomodulator and may protect against adverse pregnancy outcomes, mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), and child mortality.

Methods

A total of 884 HIV-infected pregnant women who were participating in a vitamin supplementation trial in Tanzania were monitored to assess pregnancy outcomes and child mortality. The association of these outcomes with maternal vitamin D status at enrollment was examined in an observational analysis.

Results

No association was observed between maternal vitamin D status and adverse pregnancy outcomes, including low birth weight and preterm birth. In multivariate models, a low maternal vitamin D level (<32 ng/mL) was associated with a 50% higher risk (95% confidence interval [CI], 2%–120%) of MTCT of HIV at 6 weeks, a 2-fold higher risk of MTCT of HIV through breast-feeding among children who were HIV uninfected at 6 weeks (95% CI, 1.08–3.82), and a 46% higher overall risk of HIV infection (95% CI, 11%–91%). Children born to women with a low vitamin D level had a 61% higher risk of dying during follow-up (95% CI, 25%–107%).

Conclusions

If found to be efficacious in randomized trials, vitamin D supplementation could prove to be an inexpensive method of reducing the burden of HIV infection and death among children, particularly in resource-limited settings.
Published Version: doi:10.1086/605699
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758703/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:26951082
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