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Post-natal anaemia and iron deficiency in HIV-infected women and the health and survival of their children

机译：艾滋病毒感染妇女的产后贫血和铁缺乏症及其子女的健康和生存

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Prenatal iron supplementation may improve pregnancy outcomes and decrease the risk of child mortality. However, little is known about the importance of post-natal maternal iron status for child health and survival, particularly in the context of HIV infection. We examined the association of maternal anaemia and hypochromic microcytosis, an erythrocyte morphology consistent with iron deficiency, with child health and survival in the first two to five years of life. Repeated measures of maternal anaemia and hypochromic microcytosis from 840 HIV-positive women enrolled in a clinical trial of vitamin supplementation were prospectively related to child mortality, HIV infection and CD4 T-cell count. Median duration of follow-up for the endpoints of child mortality, HIV infection and CD4 cell count was 58, 17 and 23 months, respectively. Maternal anaemia and hypochromic microcytosis were associated with greater risk of child mortality [hazard ratio (HR) for severe anaemia=2.58, 95% confidence interval (CI): 1.66-4.01, P trend < 0.0001; HR for severe hypochromic microcytosis=2.36, 95% CI: 1.27-4.38, P trend=0.001]. Maternal anaemia was not significantly associated with greater risk of child HIV infection (HR for severe anaemia=1.46, 95% CI: 0.91, 2.33, P trend=0.08) but predicted lower CD4 T-cell counts among HIV-uninfected children (difference in CD4 T-cell count/μL for severe anaemia: -93, 95% CI: -204-17, P trend=0.02). The potential child health risks associated with maternal anaemia and iron deficiency may not be limited to the prenatal period. Efforts to reduce maternal anaemia and iron deficiency during pregnancy may need to be expanded to include the post-partum period.
机译：产前补铁可改善妊娠结局并降低儿童死亡的风险。但是，人们对产后产妇铁状况对儿童健康和生存的重要性知之甚少，尤其是在感染艾滋病毒的情况下。我们检查了孕妇贫血和低色性微细胞增多症（一种与铁缺乏症相一致的红细胞形态）与儿童健康和生命的前两到五年之间的关系。 840名接受维生素补充剂临床试验的HIV阳性妇女的孕产妇贫血和低色微细胞增多症的重复测量结果与儿童死亡率，HIV感染和CD4 T细胞计数有关。儿童死亡率，HIV感染和CD4细胞计数终点的随访中位数分别为58、17和23个月。孕产妇贫血和低色素性微细胞增多症与儿童死亡的更大风险相关[严重贫血的危险比（HR）= 2.58，95％可信区间（CI）：1.66-4.01，P趋势<0.0001;严重低色性微细胞增多症的HR = 2.36，95％CI：1.27-4.38，P趋势= 0.001]。孕产妇贫血与儿童感染HIV的风险没有显着相关（严重贫血的HR = 1.46，95％CI：0.91、2.33，P趋势= 0.08），但预测未感染HIV的儿童中CD4 T细胞计数会降低（严重贫血的CD4 T细胞计数/μL：-93，95％CI：-204-17，P趋势= 0.02）。与母亲贫血和铁缺乏有关的潜在儿童健康风险可能不限于产前。可能需要扩大减少孕产妇贫血和铁缺乏的努力，以包括产后。

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