Abstract
Background:We assessed the association of polyunsaturated fatty acids in pregnant people with HIV (PWH) with pregnancy outcomes and offspring anthropometrics.Setting:This is a cohort of 264 pregnant PWH, and their HIV-exposed uninfected children, enrolled in the Pediatric HIV/AIDS Cohort Study Nutrition sub-study from 2009 to 2011.Methods:We measured third-trimester plasma omega-6 and omega-3 polyunsaturated fatty acid content, each as a percentage of total fatty acid content, through esterification and gas chromatography. Omega-6:omega-3 ratios were calculated. Pregnancy outcomes were hypertensive disorders of pregnancy, preterm birth (<37 weeks' gestation), and small-for-gestational age (birthweight <10th percentile). Childhood anthropometrics outcomes were Z-scores for age and sex: (1) weight and length/height (birth to 5 years of age), (2) head circumference (1-2 years), and (3) triceps skinfold thickness (2-5 years). Log-binomial regression models estimated pregnancy outcome prevalence ratios by omega-6:omega-3 ratios as a continuous variable. Linear regression models using generalized estimating equations assessed childhood anthropometric outcomes in those with omega-6:omega-3 ratios >25th versus ≤25th percentile.Results:Each 1% increase in the omega-6:omega-3 ratio was associated with a 25% [95% confidence interval (CI): 8 to 43] and 10% (95% CI: 3 to 18) higher prevalence of hypertensive disorders of pregnancy and preterm birth, respectively, and 13% (95% CI: 1 to 23) lower prevalence of small-for-gestational age. A difference in childhood anthropometric outcomes was not identified at any time point between exposure groups.Conclusions:Higher omega-6:omega-3 ratios in pregnant PWH were positively associated with hypertensive disorders of pregnancy and preterm birth, inversely associated with small-for-gestational age birth, and not associated with childhood anthropometric trajectories.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 300-310 |
| Number of pages | 11 |
| Journal | Journal of acquired immune deficiency syndromes (1999) |
| Volume | 99 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 2025 |
Funding
The authors acknowledge the Pediatric HIV/AIDS Cohort Study Metabolic Working Group for their support of this research, and provision of access to and use of study data for mother infant/children pairs of pregnant PWH and their HEU infants from the Dynamic Surveillance Cohort in the Nutrition sub-study of the SMARTT study protocol. The authors thank the participants for their participation in PHACS, and the individuals and institutions involved in the conduct of PHACS. The study was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), Office of the Director, National Institutes of Health (OD), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and National Heart, Lung, and Blood Institute (NHLBI) through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102) (Principal Investigator: George R Seage III; Program Director: Liz Salomon) and the Tulane University School of Medicine (HD052104) (Principal Investigator: Russell Van Dyke; Co- Principal Investigator: Ellen Chadwick; Project Director: Patrick Davis), and through Harvard T.H. Chan School of Public Health for the Pediatric HIV/AIDS Cohort Study 2020 (P01HD103133) (Multiple Principal Investigators: Ellen Chadwick, Sonia Hernandez-Diaz, Jennifer Jao, Paige Williams; Program Director: Liz Salomon). Data management services were provided by Frontier Science (Data Management Center Director: Suzanne Siminski), and regulatory services and logistical support were provided by Westat, Inc (Project Directors: Julie Davidson, Tracy Wolbach). The following institutions, clinical site investigators, and staff participated in conducting PHACS SMARTT in 2020, in alphabetical order: Ann & Robert H. Lurie Children s Hospital of Chicago: Ellen Chadwick, Margaret Ann Sanders, Kathleen Malee, Yoonsun Pyun; Baylor College of Medicine: Mary Paul, Shelley Buschur, Chivon McMullen-Jackson, Lynnette Harris; BronxCare Health System: Murli Purswani, Marvin Alvarado, Mahoobullah Mirza Baig, Alma Villegas; Children s Diagnostic & Treatment Center: Lisa-Gaye Robinson, James Blood, Patricia Garvie, Dia Cooley; New York University Grossman School of Medicine: William Borkowsky, Nagamah Sandra Deygoo, Jennifer Lewis; Rutgers - New Jersey Medical School: Arry Dieudonne, Linda Bettica, Juliette Johnson, Karen Surowiec; St. Jude Children s Research Hospital: Katherine Knapp, Jamie Russell-Bell, Megan Wilkins, Stephanie Love; San Juan Hospital Research Unit/Department of Pediatrics, San Juan Puerto Rico: Nicolas Rosario, Lourdes Angeli-Nieves, Vivian Olivera; SUNY Downstate Medical Center: Stephan Kohlhoff, Ava Dennie, Jean Kaye, Jenny Wallier; Tulane University School of Medicine: Margarita Silio, Karen Craig, Patricia Sirois; University of Alabama, Birmingham: Cecelia Hutto, Paige Hickman, Julie Huldtquist, Dan Marullo; University of California, San Diego: Stephen A. Spector, Veronica Figueroa, Megan Loughran, Sharon Nichols; University of Colorado, Denver: Elizabeth McFarland, Christine Kwon, Carrie Chambers; University of Florida, Center for HIV/AIDS Research, Education and Service: Mobeen Rathore, Jamilah Tejan, Beatrice Borestil, Staci Routman; University of Miami: Gwendolyn Scott, Gustavo Gil, Gabriel Fernandez, Anai Cuadra; Keck Medicine of the University of Southern California: Toni Frederick, Mariam Davtyan, Guadalupe Morales-Avendano; University of Puerto Rico School of Medicine, Medical Science Campus: Zoe M. Rodriguez, Lizmarie Torres, Nydia Scalley. The authors also posthumously recognize significant contributions by Tracie L. Miller Ph.D. Finally, the authors acknowledge Dr. Hannia Campos and the Fatty Acid Biomarker Laboratory at the Harvard Chan School of Public Health for processing of study samples. The study was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), Office of the Director, National Institutes of Health (OD), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and National Heart, Lung, and Blood Institute (NHLBI) through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102) (Principal Investigator: George R Seage III; Program Director: Liz Salomon) and the Tulane University School of Medicine (HD052104) (Principal Investigator: Russell Van Dyke; Co-Principal Investigator: Ellen Chadwick; Project Director: Patrick Davis), and through Harvard T.H. Chan School of Public Health for the Pediatric HIV/AIDS Cohort Study 2020 (P01HD103133) (Multiple Principal Investigators: Ellen Chadwick, Sonia Hernandez-Diaz, Jennifer Jao, Paige Williams; Program Director: Liz Salomon). Data management services were provided by Frontier Science (Data Management Center Director: Suzanne Siminski), and regulatory services and logistical support were provided by Westat, Inc (Project Directors: Julie Davidson, Tracy Wolbach). Conflicts of Interest and Source of Funding: The authors report no financial or non-financial competing interests with the data in this manuscript, or other conflict of interest to disclose. The Pediatric HIV/AIDS Cohort Study (PHACS) network is supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), Office of The Director, National Institutes of Health (OD), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Heart, Lung, and Blood Institute (NHLBI) through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102), Tulane University School of Medicine (HD052104), and Harvard T.H. Chan School of Public Health for the Pediatric HIV/AIDS Cohort Study 2020 network (P01HD103133).
Keywords
- HIV
- childhood growth
- fatty acids
- omega-3
- omega-6
- pregnancy complications
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)
