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. 2009 Oct 1;200(7):1022-30.
doi: 10.1086/605699.

Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania

Saurabh Mehta  1 , David J Hunter, Ferdinand M Mugusi, Donna Spiegelman, Karim P Manji, Edward L Giovannucci, Ellen Hertzmark, Gernard I Msamanga, Wafaie W Fawzi
Affiliations

Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania

Saurabh Mehta et al. J Infect Dis. .

Abstract

Background: Vitamin D is a strong immunomodulator and may protect against adverse pregnancy outcomes, mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), and child mortality.

Methods: A total of 884 HIV-infected pregnant women who were participating in a vitamin supplementation trial in Tanzania were monitored to assess pregnancy outcomes and child mortality. The association of these outcomes with maternal vitamin D status at enrollment was examined in an observational analysis.

Results: No association was observed between maternal vitamin D status and adverse pregnancy outcomes, including low birth weight and preterm birth. In multivariate models, a low maternal vitamin D level (<32 ng/mL) was associated with a 50% higher risk (95% confidence interval [CI], 2%-120%) of MTCT of HIV at 6 weeks, a 2-fold higher risk of MTCT of HIV through breast-feeding among children who were HIV uninfected at 6 weeks (95% CI, 1.08-3.82), and a 46% higher overall risk of HIV infection (95% CI, 11%-91%). Children born to women with a low vitamin D level had a 61% higher risk of dying during follow-up (95% CI, 25%-107%).

Conclusions: If found to be efficacious in randomized trials, vitamin D supplementation could prove to be an inexpensive method of reducing the burden of HIV infection and death among children, particularly in resource-limited settings.

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Figures

Figure 1
Figure 1
Association of maternal vitamin D level with the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection and child mortality among live births. Adjusted for maternal age at baseline, CD4 cell count, HIV disease stage, and multivitamin regimen received. Analyses of child mortality made additional adjustments for maternal death while the child was alive. Dotted lines denote 95% confidence intervals.
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