Fatty acid signatures in people with HIV: association with adverse pregnancy outcomes and offspring anthropometrics.

BACKGROUND

We assessed the association of polyunsaturated fatty acids (PUFAs) 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 2009-2011.

METHODS

We measured third-trimester plasma omega-6 and omega-3 PUFA content, each as a percentage of total fatty acid content, via 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] 8-43%) and 10% (95% CI 3-18%) higher prevalence of hypertensive disorders of pregnancy and preterm birth, respectively, and 13% (95% CI 1-23%) lower prevalence of small-for-gestational age. A difference in childhood anthropometric outcomes was not identified at any time point between exposure groups.

CONCLUSION

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.