{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:31:26Z","timestamp":1789608686815,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["NIDDK U01\u2010DK\u201018\u2010018\/019"],"award-info":[{"award-number":["NIDDK U01\u2010DK\u201018\u2010018\/019"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Outside of pregnancy, evidence shows that persons with HIV initiating or switching to dolutegravir (DTG)\u2010based antiretroviral therapy (ART) experience greater weight gain compared to those on other ART classes. However, there are few data on the impact of DTG\u2010based ART on gestational weight gain (GWG) in sub\u2010Saharan Africa where HIV is most common. According to the National Academy of Medicine (NAM), GWG below and above NAM guidelines is associated with adverse birth outcomes. Therefore, the objective of this study was to describe GWG by HIV status and ART regimen, and examine the associations with adverse birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled pregnant women with HIV (WHIV) and without HIV (\u226518 years) in a peri\u2010urban primary healthcare facility in Cape Town, South Africa between 2019 and 2022. GWG was study\u2010measured at 24\u201328 (baseline) and 33\u201338 weeks gestation and converted to GWG rate (kg\/week) in accordance with NAM guidelines. GWG z\u2010scores were generated using the INTEGROWTH\u201021 and US standards to account for differing lengths of gestation. Birth outcome data were obtained from medical records. Associations of GWG z\u2010score with adverse birth outcomes were assessed using multivariable linear or log\u2010binomial regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 292 participants (48% WHIV), median age was 29 years (IQR, 25\u201333), median pre\u2010pregnancy body mass index (BMI) was 31 kg\/m<jats:sup>2<\/jats:sup> (IQR, 26\u201336) and 20% were primiparous at baseline. The median weekly rate of GWG was 0.30 kg\/week (IQR, 0.12\u20130.50), 35% had GWG below NAM standards (59% WHIV) and 48% had GWG above NAM standards (36% WHIV). WHIV gained weight more slowly (0.25 vs. 0.37 kg\/week, <jats:italic>p<\/jats:italic>&lt;0.01) than women without HIV. Weekly rate of GWG did not differ by ART regimen (DTG\u2010based ART 0.25 vs. efavirenz\u2010based ART 0.27 kg\/week, <jats:italic>p<\/jats:italic> = 0.80). In multivariable analyses, GWG z\u2010score was positively associated with continuous birth weight (mean difference = 68.53 95% CI 8.96, 128.10) and categorical high birth weight of &gt;4000 g (RR = 2.18 95% CI 1.18, 4.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite slower GWG among WHIV, nearly half of all women gained weight faster than recommended by the NAM. GWG was positively associated with infant birth weight. Interventions to support healthy GWG in sub\u2010Saharan Africa are urgently needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26313","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T04:29:57Z","timestamp":1719462597000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Gestational weight gain and adverse birth outcomes in South African women with HIV on antiretroviral therapy and without HIV: a prospective cohort study"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7759-3498","authenticated-orcid":false,"given":"Hlengiwe P.","family":"Madlala","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Biostatistics School of Public Health, University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Landon","family":"Myer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics School of Public Health, University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-6040","authenticated-orcid":false,"given":"Jennifer","family":"Jao","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Division of Infectious Diseases, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayli","family":"Geffen","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics School of Public Health, University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mushi","family":"Matjila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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