Revista Brasileira de Ginecologia e Obstetrícia (Aug 2011)
Características epidemiológicas e nutricionais de gestantes vivendo com o HIV Epidemiological and nutritional characteristics of pregnant HIV-infected women
Abstract
OBJETIVO: Caracterizar o perfil epidemiológico e nutricional de gestantes com o vírus da imunodeficiência humana (HIV) e os efeitos dessa infecção sobre o estado nutricional dessas mulheres durante a gravidez. MÉTODOS: Foi feito um estudo de coorte retrospectivo onde foram incluídas 121 gestantes com diagnóstico de infecção pelo HIV, gestação de feto único, que frequentaram pré-natal e fizeram o parto em uma unidade de referência para gestantes vivendo com HIV, no período de 1997 a 2007. Desfechos do estudo foram o estado nutricional inicial e final, avaliado pelo índice de massa corporal, o ganho ponderal, a anemia (hemoglobina PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
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