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Biomedical subjects

Karen E Peterson

Publications and source records attributed to Karen E Peterson.

At least 19 recordsLinked to original sources
PubMed2006

Maternal social and pyschological conditions and physical growth in low-income children in Piauí, Northeast Brazil.

Prevalence of child undernutrition remains high in many developing countries. In settings with scarce resources, modifiable maternal social conditions may influence feeding and parenting practices, in turn affecting child growth. This study aims to quantify the association between maternal social support and depression to children's physical growth outcomes in Teresina, Piauí, northeast Brazil. Interviews were conducted with a random sample of 595 mothers of children 6-24 months old in four low-income sections of Teresina, Piauí. We collected data on sociodemographic factors, mothers' social support, mothers' depressive symptomatology, and child's weight and recumbent length. Weight-for-height z-scores (WHZ), height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) were calculated using the National Center for Chronic Disease Prevention and Health Promotion Center SAS program based on the 2000 Centers for Disease Control reference growth curves. Multivariable linear regression was used to model the association between maternal social support and depression to child growth, adjusting for biological and socio-demographic variables. Interviewer and neighborhood variation was accounted for through the inclusion of random effects. In adjusted models, material support, measured by number of friends or family members available to mothers when needing food or milk, was related to 0.3 higher average WHZ and 0.2 higher average WAZ in their children. Maternal positive social interaction, which reflects engagement in leisure-time activities with others, was associated with 0.3 higher average WHZ. Mothers' affectionate support was related to 0.2 higher average children's WHZ and WAZ, whereas social support for resolving a conflict was associated with 0.2 lower average HAZ. Maternal depression was not associated with child growth. It is concluded that inadequate growth in children may be sensitive to maternal social support.

Brazil↗
PubMed2006

Conceptualization and development of a theory-based healthful eating and physical activity intervention for postpartum women who are low income.

Eating and physical activity behaviors that confer risk for chronic disease are prominent among women from varying ethnic and racial groups who are low income. Conceptualization and development of a theory-based behavioral intervention to address their unique needs during the first year following childbirth comprised four steps: (a) translating public health guidelines and emerging epidemiologic data into specific intervention messages; (b) developing practical strategies to operationalize theoretical constructs, in the context of a social ecological framework; (c) stating achievement-based objectives and writing scripts for five home visits; and (d) conducting formative research. Focus group participants expressed a desire for a "health mentor," not somebody who "nags" or "stresses you out." Paraprofessionals from the Expanded Food and Nutrition Education Program (EFNEP) were directly involved in pretesting the intervention and remain involved as health mentors. This intervention can serve as a basis for future organizational partnerships to benefit the health of populations who are low income.

Adult↗
PubMed2006

Biomarker validation of dietary intervention in two multiethnic populations.

INTRODUCTION: Intervention studies have been designed to change dietary and lifestyle factors associated with chronic diseases, but self-reported behavior change may incorporate intervention-related bias. This study examines plasma nutrient concentration and correlations with self-reports in the Healthy Directions intervention study. The Healthy Directions intervention studies were designed to increase multivitamin use, fruit and vegetable consumption, and physical activity in working-class, multiethnic populations. METHODS: Participants in both studies completed interviewer-administered questionnaires that collected information on sociodemographic and health behavior characteristics. Postintervention blood samples were collected from 209 participants and pooled in pairs within study and within intervention group. RESULTS: We found significantly higher plasma concentrations of retinol (P = .01) and alpha-carotene (P = .03) in the intervention than in the usual care group. Self-reported multivitamin users had significantly higher concentrations of retinol (P < .001), beta-carotene (P = .02), and alpha-tocopherol (P < .001). Those who reported four or more fruit and vegetable servings per day had higher lutein and zeaxanthin (P = .05) and beta-cryptoxanthin (P = .05) concentrations than those consuming fewer. Plasma nutrient concentrations were associated with reported multivitamin use and fruit and vegetable intake, but the correlations were generally higher in the usual care group. CONCLUSION: We found significant postintervention differences in plasma carotenoid and tocopherol concentrations by treatment group, multivitamin use, and fruit and vegetable intake. However, because we only obtained postintervention blood samples, we were unable to assess preintervention-to-postintervention changes in plasma nutrients. Self-reported intakes were significantly correlated with plasma nutrient concentrations, but the strength of the correlations differed by group, suggesting some intervention-related bias in the questionnaire responses.

Biomarkers↗
PubMed2006

When children eat what they watch: impact of television viewing on dietary intake in youth.

OBJECTIVES: To test whether increased television viewing is associated with increased total energy intake and with increased consumption of foods commonly advertised on television, and to test whether increased consumption of these foods mediates the relationship between television viewing and total energy intake. DESIGN: Prospective observational study with baseline (fall 1995) and follow-up (spring 1997) measures of youth diet, physical activity, and television viewing. We used food advertising data to identify 6 food groups for study (sweet baked snacks, candy, fried potatoes, main courses commonly served as fast food, salty snacks, and sugar-sweetened beverages). SETTING AND PARTICIPANTS: Five public schools in 4 communities near Boston. The sample included 548 students (mean age at baseline, 11.70 years; 48.4% female; and 63.5% white). MAIN OUTCOME MEASURES: Change in total energy intake and intake of foods commonly advertised on television from baseline to follow-up. RESULTS: After adjusting for baseline covariates, each hour increase in television viewing was associated with an additional 167 kcal/d (95% confidence interval, 136-198 kcal/d; P<.001) and with increases in the consumption of foods commonly advertised on television. Including changes in intakes of these foods in regression models provided evidence of their mediating role, diminishing or rendering nonsignificant the associations between change in television viewing and change in total energy intake. CONCLUSIONS: Increases in television viewing are associated with increased calorie intake among youth. This association is mediated by increasing consumption of calorie-dense low-nutrient foods frequently advertised on television.

Advertising↗
PubMed2006

The role of social networks and support in postpartum women's depression: a multiethnic urban sample.

OBJECTIVES: This study examined the relationship of social support, and of social networks, to symptoms of depression in a multiethnic sample of women having recently given birth. METHODS: Women at community health centers in a Northeastern city were randomly sampled from groups stratified by race/ethnicity (African American, Hispanic, and White) and postpartum interval. Mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) was the dependent variable. Main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. Univariate statistics assessed the relationship between CES-D score and each of the independent variables. Multivariate linear regression models included core sociodemographic variables alone, the core model with each of the social support and social network variables added separately, and all variables together. We evaluated interactions between race and social support, race and social networks, and social support and social networks. RESULTS: The multivariate models with MOS Social Support and core variables indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the CES-D (95% CI -2.4, -1.7). The inclusion of the social network variable into the core model showed that having two or more friends or family members available was associated with a 13.6-point lower mean score on the CES-D (95% CI -17.5, -9.6), compared to women reporting none or only one available person. CONCLUSIONS: Both social support and social networks were statistically significant and independently related to depressive symptomatology.

Adult↗
PubMed2006

School vending machine use and fast-food restaurant use are associated with sugar-sweetened beverage intake in youth.

OBJECTIVE: To examine associations between use of school vending machines and fast-food restaurants and youth intake of sugar-sweetened beverages. DESIGN: A cross-sectional observational study. SUBJECTS/SETTING: From a group randomized obesity intervention, we analyzed baseline data from 1,474 students in 10 Massachusetts middle schools with vending machines that sold soda and/or other sweetened drinks. MAIN OUTCOME MEASURES: Daily sugar-sweetened beverage consumption (regular soda, fruit drinks, and iced tea), purchases from school vending machines, and visits to fast-food restaurants in the preceding 7 days were estimated by self-report. STATISTICAL ANALYSES PERFORMED: Chi(2) and nonparametric tests were performed on unadjusted data; multivariable models adjusted for sex, grade, body mass index, and race/ethnicity, and accounted for clustering within schools. RESULTS: Among 646 students who reported using school vending machines, 456 (71%) reported purchasing sugar-sweetened beverages. Overall, 977 students (66%) reported eating at a fast-food restaurant. Sugar-sweetened beverage intakes averaged 1.2 servings per day. In adjusted models, relative to no vending machine purchases, servings per day increased by 0.21 for one to three purchases per week (P=0.0057), and 0.71 with four or more purchases (P<0.0001). Relative to no fast-food restaurant visits, sugar-sweetened beverage servings per day increased by 0.13 with one visit per week (P=0.07), 0.49 with two to three visits (P=0.0013), and by 1.64 with four or more visits (P=0.0016). CONCLUSIONS: Among students who use school vending machines, more report buying sugar-sweetened beverages than any other product category examined. Both school vending machine and fast-food restaurant use are associated with overall sugar-sweetened beverage intake. Reduction in added dietary sugars may be attainable by reducing use of these sources or changing product availability.

Adolescent↗
PubMed2006

Trends in overweight from 1980 through 2001 among preschool-aged children enrolled in a health maintenance organization.

OBJECTIVE: To examine overweight trends over a 22-year period among preschool-aged children from primarily middle-income families enrolled in a health maintenance organization. RESEARCH METHODS AND PROCEDURES: From well-child care visits to a Massachusetts health maintenance organization, we randomly selected one visit per child per calendar year, yielding a study sample of 120,680 children seen at 366,109 visits from 1980 through 2001. Using multivariate logistic regression models accounting for repeated observations of individual children across years, we estimated trends in prevalence of overweight (weight-for-length/height > or = 95th percentile) and at-risk-for-overweight (85th to 95th percentile). RESULTS: Over the 22-year study period, the observed prevalence of overweight increased from 6.3% to 10.0% and at-risk-for-overweight increased from 11.1% to 14.4%. These increases were evident among all groups of children including infants < 6 months of age. Overall, the adjusted odds ratios were 1.21 per decade (95% confidence interval, 1.17 to 1.25) for overweight and 1.06 per decade (95% confidence interval, 1.03 to 1.08) for at-risk-for-overweight. DISCUSSION: Rates of overweight are increasing in very young children, even infants, from primarily middle-class families.

Child, Preschool↗
PubMed2005

Influence of maternal bone lead burden and calcium intake on levels of lead in breast milk over the course of lactation.

The authors studied 367 women who were breastfeeding their infants in Mexico City, Mexico, between 1994 and 1995 to evaluate the effect of cumulative lead exposure, breastfeeding practices, and calcium intake on breast milk lead levels over the course of lactation. Maternal blood and breast milk lead levels were measured at 1, 4, and 7 months postpartum. Bone lead measurements were obtained at 1 month postpartum. At 1, 4, and 7 months postpartum, respectively, the mean breast milk lead levels were 1.4 (standard deviation (SD), 1.1), 1.2 (SD, 1.0), and 0.9 (SD, 0.8) microg/liter and showed a significant decreasing trend over the course of lactation (p < 0.00001). The relations of bone lead and blood lead to breast milk lead were modified by breastfeeding practice, with the highest breast milk lead levels among women with a high level of patella lead who were exclusively breastfeeding. Dietary calcium supplementation increased the rate of decline in breast milk lead by 5-10%, in comparison with a placebo, over the course of lactation, suggesting that calcium supplementation may constitute an important intervention strategy, albeit with a modest effect, for reducing lead in breast milk and thus the potential for exposure by infants.

Adult↗
PubMed2005

Incidence and remission rates of overweight among children aged 5 to 13 years in a district-wide school surveillance system.

OBJECTIVES: To monitor annual changes in weight status, we determined incidence and remission rates of overweight among school-aged children with longitudinal school-based surveillance. METHODS: We estimated 1-year changes in weight status among students enrolled in public schools in Cambridge, Mass. Physical education teachers measured height and weight annually. Adjusted odds ratios (ORs) were estimated via multivariate logistic regression, accounting for repeated observations of individual children across years. RESULTS: The 1-year incidence of overweight was 4%, and the remission rate was 15%. Among overweight children, 85% remained overweight at a 1-year follow-up, while 18% of children at risk for overweight became overweight. Overweight incidence rates were higher among children aged 7 and 8 years than among those aged 11 to 13 years (boys: OR=1.68; 95% confidence interval [CI]=1.14, 2.47; girls: OR=1.86; 95% CI=1.25, 2.77). CONCLUSIONS: Both incidence and remission rates were higher among younger children. Children who were at risk for overweight were more likely to change their weight status than those who were already overweight. Our results support targeting overweight prevention efforts toward younger children and children at risk for overweight.

Adolescent↗
PubMed2005

The impact of a school-based obesity prevention trial on disordered weight-control behaviors in early adolescent girls.

OBJECTIVE: To assess the impact of an obesity prevention intervention on use of self-induced vomiting/laxatives (purging) and diet pills to control weight in girls in early adolescence. DESIGN: We matched and randomly assigned 10 middle schools to an intervention or a control condition in a randomized controlled trial. Longitudinal multivariable analyses using generalized estimating equations were conducted with data from 480 girls to examine the effects of the intervention on the risk of reporting a new case of purging or diet pill use to control weight at follow-up 21 months later, while controlling for ethnicity and school matched pairs. Girls who reported purging or using diet pills at baseline were excluded from analyses. SETTING: Middle schools. PARTICIPANTS: Four hundred eighty girls in early adolescence aged 10 to 14 years (mean age, 11.5 years). INTERVENTION: The Planet Health obesity prevention program was implemented during 2 school years and was designed to promote healthful nutrition and physical activity and to reduce television viewing. OUTCOME: Reduced risk of using self-induced vomiting/laxatives or diet pills to control weight in the past 30 days. RESULTS: After the intervention, we found 14 (6.2%) of 226 girls in control schools and 7 (2.8%) of 254 girls in intervention schools reported purging or using diet pills to control their weight (P = .003). In a multivariable generalized estimating equation model, girls in intervention schools were less than half as likely to report purging or using diet pills at follow-up compared with girls in control schools (odds ratio, 0.41; 95% confidence interval, 0.22-0.75). CONCLUSION: These findings provide promising evidence that school-based interventions may effectively integrate prevention of both obesity and disordered weight-control behaviors.

Adolescent↗
PubMed2005

Effects of a school-based obesity-prevention intervention on menarche (United States).

OBJECTIVE: Early menarche is a risk factor for breast cancer. Since body composition influences age at menarche we decided to estimate the effects of a school-based intervention for the prevention of obesity on the initiation of menses in young girls. METHODS: Ten schools were randomized to a modified curriculum or no curricular changes for 2 school-years. Data of 508 pre-menarcheal girls at baseline (age range: 10-13 years) were analyzed. RESULTS: Girls attending an intervention school experienced menarche less frequently than girls attending control schools during the intervention period (intervention schools = 54%, control schools = 59%; RR = 0.76; 95% CI [0.66, 0.87]). Attending an intervention school was also associated with lower increase in BMI (-0.3 kg/m2; p = 0.003), lower gains in triceps skinfold thickness (-1.5 mm; p = 0.007), decreased television viewing (-0.6 h/day; p<0.0001) and increased physical activity (3.1 MET-h/week; p = 0.032). Including these changes as predictors of menarche incidence attenuated the intervention effect (RR = 0.94; 95% CI [0.80, 1.10]). CONCLUSIONS: The intervention delayed menarche in this group of girls. The delay was produced by increased physical activity, reduced television viewing and changes in BMI and fat distribution. These findings may have implications for the primary prevention of breast cancer.

Adolescent↗
PubMed2005

Relationship of physical fitness to prevalence and incidence of overweight among schoolchildren.

OBJECTIVES: We examined the relationship between comprehensive fitness tests and overweight using a school surveillance system in a racially diverse city in the United States. RESEARCH METHODS AND PROCEDURES: Trained physical education teachers measured weight, height, and fitness annually from 2001 to 2003. We compiled data for a cross-sectional analysis (11,845 measurements on 6297 students, 5 to 14 years of age) and a 1-year prospective analysis (4215 measurements on 2927 students not overweight at baseline, 5 to 13 years of age). Overweight was defined as a BMI > or =95th percentile (Centers for Disease Control and Prevention 2000 growth charts), and underfit was defined as failing at least one of five fitness tests: endurance run, abdominal strength, flexibility, upper body strength, and agility (Amateur Athletic Union and Fitnessgram). Associations between fitness and overweight were examined using multivariate logistic regression models, adjusting for sociodemographic status and repeated measurements over time. RESULTS: The mean number of fitness tests passed was lower among students with a BMI above the 80th percentile. Overweight incidence over 1 year was 7% and 2% for underfit and fit girls, respectively (odds ratio, 3.3; 95% confidence interval, 2.0 to 5.6). Not passing either the endurance run or upper body strength test was associated with overweight incidence in both boys and girls. After adjusting for baseline BMI, the endurance run remained a significant predictor of incident overweight among girls (odds ratio, 2.0; 95% confidence interval, 1.1 to 3.5). DISCUSSION: Findings support a cross-sectional inverse relationship between physical fitness and overweight among school-aged children. The direction of causation between fitness and overweight is not clearly established and merits further study.

Adolescent↗
PubMed2004

Beverage consumption is not associated with changes in weight and body mass index among low-income preschool children in North Dakota.

OBJECTIVE: To examine prospectively the association between beverage consumption (fruit juice, fruit drinks, milk, soda, and diet soda) and changes in weight and body mass index among preschool children. DESIGN: A prospective cohort study that collected dietary, anthropometric, and sociodemographic data.Subjects/Setting The study population included 1,345 children age 2 to 5 years participating in the North Dakota Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on two visits between 6 to 12 months apart. Statistical analyses We performed linear regression analyses to examine whether beverage consumption was associated with annual change in weight and body mass index. Intakes were measured as continuous (oz/day) and we also dichotomized fruit juice, fruit drinks, and milk at high intakes. RESULTS: In multivariate regression analyses adjusted for age, sex, energy intake, change in height, and additional sociodemographic variables, weight change was not significantly related to intakes (per ounce) of fruit juice (beta=0.01 lb/year, 95% CI: -0.01 to 0.20, P=.28), fruit drinks (beta=-0.03 lb/year, 95% CI: -0.07 to 0.01, P=.28), milk (beta=0.00 lb/year, 95% CI: -0.02 to 0.02, P=.86), soda (beta=-0.00 lb/year, 95% CI: -0.08 to 0.08, P=.95), or diet soda (beta=0.01 lb/year, 95% CI: -0.11 to 0.13, P=.82). Findings remained null when we examined associations with body mass index and when fruit juice, fruit drinks, and milk were dichotomized at high intake levels in both analyses. CONCLUSIONS: Our study does not show an association between beverage consumption and changes in weight or body mass index in this population of low-income preschool children in North Dakota.

Beverages↗
PubMed2004

Youth recall and TriTrac accelerometer estimates of physical activity levels.

PURPOSE: To examine significance of missing data and describe physical activity patterns using recall and accelerometer measures among youth in a nonlaboratory setting. METHODS: Fifty-four middle-school students wore TriTrac-R3D monitors (TTM) and completed an interviewer-prompted 24-h recall during two, 5-d monitoring sessions. We coded 2860 30-min recall intervals to a standard MET compendium. Complete TTM data were gathered for 43 students. Ordinal multinomial models tested for bias in TTM estimates of activity levels due to: 1) exclusion of subjects with incomplete TTM data, and 2) exclusion of intervals within days due to missing TTM data. RESULTS: Students with complete monitor data had an average 12.5 +/- 0.9 monitored hours per day over 5.5 +/- 2.1 d. Compared with students with incomplete monitoring data, they reported similar proportions of recall 30-min intervals at sedentary (68% vs 69%), light (14% vs 15%), moderate (11% vs 10%), and vigorous (7% vs 6%) intensity levels (P = 0.63). The proportion of recall intervals (within days) with and without simultaneous monitoring data did not differ by activity intensity (P = 0.64) across sedentary (69% vs 67%), light (14% vs 12%), moderate (11% vs 10%), and vigorous (6% vs 9%) categories. Recalls overestimated percent time per day in moderate and vigorous activity relative to TTM (22.8% vs 8.9%, P < 0.0001). Boys reported higher percent of time than girls in vigorous activity (10.9% vs 3.9%, P < 0.05). Girls reported more time than boys (9.5% vs 6.4%, P < 0.05) in light activities. No significant sex differences were observed using TTM. CONCLUSIONS: Missing TTM data did not bias estimates of activity levels. Self-reported activity measures overestimated moderate and vigorous activity relative to the TTM and varied by sex.

Adolescent↗
PubMed2004

Effect of succimer on growth of preschool children with moderate blood lead levels.

Growth deficits associated with lead exposure might be ameliorated by chelation. We examined the effect of succimer on growth in 780 children 12-33 months old who had blood lead levels of 20-44 microg/dL and were randomized to receive up to three 26-day courses of succimer or placebo in a multicenter, double-blind trial. The difference in changes in weight and height between succimer and placebo groups at 1-34 months was calculated by fitting cubic splines. The difference in height change in children on succimer compared with placebo was -0.27 cm [95% confidence interval (95% CI), -0.42 to -0.11] from baseline to 9 months, when 99% of children had completed treatment, and -0.43 cm (95% CI, -0.77 to -0.09) during 34 months of follow-up. Similar differences in weight gain were not statistically significant. Although succimer lowers blood lead in moderately lead-poisoned children, it does not have a beneficial effect on growth and may have an adverse effect.

Body Height↗
PubMed2004

Levels of lead in breast milk and their relation to maternal blood and bone lead levels at one month postpartum.

Despite the many well-recognized benefits of breast-feeding for both mothers and infants, detectable levels of lead in breast milk have been documented in population studies of women with no current environmental or occupational exposures. Mobilization of maternal bone lead stores has been suggested as a potential endogenous source of lead in breast milk. We measured lead in breast milk to quantify the relation between maternal blood and bone lead levels and breast-feeding status (exclusive vs. partial) among 310 lactating women in Mexico City, Mexico, at 1 month postpartum. Umbilical cord and maternal blood samples were collected at delivery. Maternal breast milk, blood, and bone lead levels were obtained at 1 month postpartum. Levels of lead in breast milk ranged from 0.21 to 8.02 microg/L (ppb), with a geometric mean (GM) of 1.1 microg/L; blood lead ranged from 1.8 to 29.9 microg/dL (GM = 8.4 microg/dL); bone lead ranged from < 1 to 67.2 microg/g bone mineral (patella) and from < 1 to 76.6 microg/g bone mineral (tibia) at 1 month postpartum. Breast milk lead was significantly correlated with umbilical cord lead [Spearman correlation coefficient (rS) = 0.36, p < 0.0001] and maternal blood lead (rS= 0.38, p < 0.0001) at delivery and with maternal blood lead (rS = 0.42, p < 0.0001) and patella lead (rS= 0.15, p < 0.01) at 1 month postpartum. Mother's age, years living in Mexico City, and use of lead-glazed ceramics, all predictive of cumulative lead exposure, were not significant predictors of breast milk lead levels. Adjusting for parity, daily dietary calcium intake (milligrams), infant weight change (grams), and breast-feeding status (exclusive or partial lactation), the estimated effect of an interquartile range (IQR) increase in blood lead (5.0 microg/dL) was associated with a 33% increase in breast milk lead [95% confidence interval (CI), 24 to 43%], whereas an IQR increase in patella lead (20 microg/g) was associated with a 14% increase in breast milk lead (95% CI, 5 to 25%). An IQR increase in tibia lead (12.0 microg/g) was associated with a 5% increase in breast milk lead (95% CI, -3% to 14%). Our results indicate that even among a population of women with relatively high lifetime exposure to lead, levels of lead in breast milk are low, influenced both by current lead exposure and by redistribution of bone lead accumulated from past environmental exposures.

Adolescent↗
PubMed2003

Pattern and predictors of weight gain during pregnancy among HIV-1-infected women from Tanzania.

Progression of HIV disease is often accompanied by weight loss and wasting. Gestational weight gain is a strong determinant of maternal and neonatal outcomes; however, the pattern and predictors of weight gain during pregnancy among HIV-positive women are unknown. We obtained monthly anthropometric measurements in a cohort of 957 pregnant women from Tanzania who were HIV infected. We estimated the weekly rate of weight gain at various points during the second and third trimesters of pregnancy and computed rate differences between levels of sociodemographic, nutritional, immunologic, and parasitic variables at the first prenatal visit. The change in mid-upper arm circumference (MUAC) from baseline to delivery was also examined. The rate of weight gain decreased progressively during pregnancy. There was an average decline of 1 cm in MUAC between weeks 12 and 38. Lower level of education and helminthic infections at first visit were associated with decreased adjusted rates of weight gain during the third trimester. High baseline MUAC, not contributing to household income, lower serum retinol and selenium concentrations, advanced clinical stage of HIV disease, and malaria infection were related to decreased rates of weight gain during the second trimester. Low baseline CD4 T-cell counts were related to a poorer pattern of weight gain throughout pregnancy. Prevention and treatment of parasitic infections and improvement of nutritional status are likely to enhance the pattern of gestational weight gain among HIV-infected women.

Arm↗