The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans
Objectives: First, to explore the independent associations between obesity, HIV (with ARV treatment), and anaemia and delivery outcomes in urban South African women and, second, to identify any potential interactions between these co-morbidities.Design: Longitudinal observational cohort study.Settin...
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Taylor & Francis Group
2025-04-01
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| Series: | The South African Journal of Clinical Nutrition |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16070658.2025.2484902 |
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| author | Alessandra Prioreschi Stephanie V Wrottesley Linda Adair Kate A Ward Shane A Norris |
| author_facet | Alessandra Prioreschi Stephanie V Wrottesley Linda Adair Kate A Ward Shane A Norris |
| author_sort | Alessandra Prioreschi |
| collection | DOAJ |
| description | Objectives: First, to explore the independent associations between obesity, HIV (with ARV treatment), and anaemia and delivery outcomes in urban South African women and, second, to identify any potential interactions between these co-morbidities.Design: Longitudinal observational cohort study.Setting: Soweto, South Africa.Subjects: Mother–infant pairs (789) were recruited when mothers were < 20 weeks pregnant.Outcome measures: Infant gestational age at delivery was calculated, and infant birth weight and length were measured by trained research nurses. Head circumference was measured using a metal head circumference tape measure. Multivariable linear regression and logistic regression models were used to test the associations between obesity, HIV-positive status, and anaemia and delivery outcomes, as well as the potential interactions between the triple burden exposures.Results: At baseline, 14%, 11%, and 22% of women were diagnosed with only obesity, HIV, or anaemia respectively, while 42% had two conditions and 5% were exposed to the triple burden. Maternal obese vs. non-obese status was associated with a 0.32 higher weight-to-length z-score at birth (p < 0.01) and a 2.93 times higher risk of a large-for-gestational age delivery (p < 0.01). There were no interactions between the triple burden exposures on delivery outcomes.Conclusions: This study presents evidence for the importance of prioritising obesity prevention prior to conception in urban African settings such as South Africa. In addition, our findings highlight the need for more research into the complex relationships between maternal co-morbidities, as well as their potential influence (alone and in combination) on maternal and offspring health in the short and longer term. |
| format | Article |
| id | doaj-art-f49b727aeb104a7d9ca4cd47cb61e01c |
| institution | DOAJ |
| issn | 1607-0658 2221-1268 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | The South African Journal of Clinical Nutrition |
| spelling | doaj-art-f49b727aeb104a7d9ca4cd47cb61e01c2025-08-20T03:23:02ZengTaylor & Francis GroupThe South African Journal of Clinical Nutrition1607-06582221-12682025-04-013829110010.1080/16070658.2025.2484902The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South AfricansAlessandra Prioreschi0Stephanie V Wrottesley1Linda Adair2Kate A Ward3Shane A Norris4SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South AfricaSAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USASAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South AfricaSAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South AfricaObjectives: First, to explore the independent associations between obesity, HIV (with ARV treatment), and anaemia and delivery outcomes in urban South African women and, second, to identify any potential interactions between these co-morbidities.Design: Longitudinal observational cohort study.Setting: Soweto, South Africa.Subjects: Mother–infant pairs (789) were recruited when mothers were < 20 weeks pregnant.Outcome measures: Infant gestational age at delivery was calculated, and infant birth weight and length were measured by trained research nurses. Head circumference was measured using a metal head circumference tape measure. Multivariable linear regression and logistic regression models were used to test the associations between obesity, HIV-positive status, and anaemia and delivery outcomes, as well as the potential interactions between the triple burden exposures.Results: At baseline, 14%, 11%, and 22% of women were diagnosed with only obesity, HIV, or anaemia respectively, while 42% had two conditions and 5% were exposed to the triple burden. Maternal obese vs. non-obese status was associated with a 0.32 higher weight-to-length z-score at birth (p < 0.01) and a 2.93 times higher risk of a large-for-gestational age delivery (p < 0.01). There were no interactions between the triple burden exposures on delivery outcomes.Conclusions: This study presents evidence for the importance of prioritising obesity prevention prior to conception in urban African settings such as South Africa. In addition, our findings highlight the need for more research into the complex relationships between maternal co-morbidities, as well as their potential influence (alone and in combination) on maternal and offspring health in the short and longer term.https://www.tandfonline.com/doi/10.1080/16070658.2025.2484902co-morbiditieshealth burdenneonate sizepregnancy health |
| spellingShingle | Alessandra Prioreschi Stephanie V Wrottesley Linda Adair Kate A Ward Shane A Norris The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans The South African Journal of Clinical Nutrition co-morbidities health burden neonate size pregnancy health |
| title | The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans |
| title_full | The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans |
| title_fullStr | The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans |
| title_full_unstemmed | The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans |
| title_short | The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans |
| title_sort | triple burden of obesity hiv and anaemia during pregnancy and associations with delivery outcomes in urban south africans |
| topic | co-morbidities health burden neonate size pregnancy health |
| url | https://www.tandfonline.com/doi/10.1080/16070658.2025.2484902 |
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