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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000428
HIV Reports: PDF Only

Vitamin D Insufficiency in HIV-Infected Pregnant Women Receiving Antiretroviral Therapy is not associated with Morbidity, Mortality or Growth Impairment in Their Uninfected Infants in Botswana.

Powis, Kathleen MD, MPH; Lockman, Shahin MD, MSc; Smeaton, Laura MS; Hughes, Michael D. PhD; Fawzi, Wafaie MB BS, DrPH; Ogwu, Anthony MB, BS; Moyo, Sikhulile; van Widenfelt, Erik; von Oettingen, Julia MD; Makhema, Joseph MB, ChB, MRCP; Essex, Max DVM, PhD; Shapiro, Roger L. MD, MPH

Published Ahead-of-Print
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Background: Low maternal 25(OH)D (vitamin D) values have been associated with higher mortality and impaired growth among HIV-exposed uninfected (HEU) infants of antiretroviral (ART)-naive women. These associations have not been studied among HEU infants of women receiving ART.

Methods: We performed a nested case-control study in the Botswana Mma Bana Study, a study providing ART to women during pregnancy and breastfeeding. Median maternal vitamin D values, and the proportion with maternal vitamin D insufficiency, were compared between women whose HEU infants experienced morbidity/mortality during 24 months of follow-up and women with non-hospitalized HEU infants. Growth faltering was assessed for never hospitalized infants attending the 24-month-of-life visit. Multivariate logistic regression models determined associations between maternal vitamin D insufficiency and infant morbidity/mortality and growth faltering.

Results: Delivery plasma was available and vitamin D levels assayable from 119 (86%) of 139 cases and 233 (84%) of 278 controls, and did not differ significantly between cases and controls (median 36.7 ng/mL; IQR 29.1- 44.7 vs. 37.1 ng/mL; IQR 30.0 - 47.2; p = 0.32). Vitamin D insufficiency (< 32 ng/mL) was recorded among 112 (31.8%) of 352 women at delivery and occurred most frequently among women delivering in winter. Multivariate logistic regression models adjusted for maternal HIV disease progression did not show associations between maternal vitamin D insufficiency at delivery and child morbidity/mortality, or 24-month-of-life growth faltering.

Conclusions: Vitamin D insufficiency was common among ART treated pregnant women in Botswana, but was not associated with morbidity, mortality or growth impairment in their HIV-uninfected children.

(C) 2014 by Lippincott Williams & Wilkins, Inc.


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