Maternal Traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban black South Africans

摘要

This study examines the associations between maternal Traditional dietary pattern adherence and HIV/treatment with neonatal size and adiposity in urban, black South Africans, as well as how specific maternal factors - i.e. BMI and GWG - may influence these associations. Multiple linear regression models were used to examine associations between maternal Traditional diet pattern adherence (pattern score), HIV/treatment status [three groups: HIV negative, HIV positive (antenatal antiretroviral treatment (ART) initiation), HIV positive (pre-pregnancy ART initiation)], BMI and GWG (kg/week) and: newborn (1) weight-to-length ratio (WLR, kg/m) in 393 mother-neonate pairs; (2) Peapod estimated fat mass index (FMI, kg/m3) in a 171-pair subsample. In fully adjusted models, maternal obesity and GWG were associated with 0.25 kg/m (P=0.008) and 0.48 kg/m (P=0.002) higher newborn WLR, while Traditional diet pattern score was associated with lower newborn WLR (-0.04 kg/m per +1 SD; P=0.033). Additionally, Traditional diet pattern score was associated with 0.13 kg/m3 (P=0.027) and 0.32 kg/m3 (P=0.005) lower FMI in the total sample and in newborns of normal weight women, respectively. HIV positive (pre-pregnancy ART) vs. HIV negative (ref) status was associated with 1.11 kg/m3 (P=0.002) higher newborn FMI. Promotion of a Traditional dietary pattern, alongside a healthy maternal pre-conception weight, in South African women may reduce newborn adiposity and metabolic risk profiles. In HIV-positive women, targeted monitoring and management strategies are necessary to limit treatment-associated effects on in utero fat deposition.