Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania.

Full 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.

Author information

Author/s: Mehta, Saurabh (S); Hunter, David J (DJ); Mugusi, Ferdinand M (FM); Spiegelman, Donna (D); Manji, Karim P (KP); Giovannucci, Edward L (EL); Hertzmark, Ellen (E); Msamanga, Gernard I (GI); Fawzi, Wafaie W (WW);

Affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA. smehta(-atsign-)hsph.harvard.edu

Grants: D43 TW00004 (Agency:FIC NIH HHS) ; R01 32257 (Agency:PHS HHS)

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: The Journal of infectious diseases (J Infect Dis), published in United States. (Language: eng)

Reference: 2009-Oct; vol 200 (issue 7) : pp 1022-30

Dates: Created 2009/09/02; Completed 2009/10/28;

PMID: 19673647, status: MEDLINE (last retrieval date: 10/28/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Infect Dis. 2009 Oct 1;200(7):1015-7. (PMID: 19673648)

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