Peer-reviewed article
Fatty acid signatures in people with HIV: association with adverse pregnancy outcomes and offspring anthropometrics.
Stephanie A Fisher, Jennifer Jao, Lynn M Yee, Lena Serghides, Ellen G Chadwick et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how the balance of fatty acids in the blood of pregnant women with HIV affects pregnancy complications and their babies' growth. Researchers measured omega-6 and omega-3 fatty acids in 264 pregnant women with HIV and followed their babies' growth for several years. They found that an imbalance toward more omega-6 fatty acids was linked to higher rates of dangerous high blood pressure during pregnancy and early birth, though it was linked to lower rates of babies being small at birth. The babies' growth in early childhood was not affected by the mothers' fatty acid levels.
Key points
- Each 1% increase in the omega-6:omega-3 ratio was associated with a 25% higher prevalence of hypertensive disorders of pregnancy
- Each 1% increase in the omega-6:omega-3 ratio was associated with a 10% higher prevalence of preterm birth
- Higher omega-6:omega-3 ratios were inversely associated with small-for-gestational age birth (13% lower prevalence)
- No differences in childhood anthropometric outcomes (weight, height, head circumference, skinfold thickness) were found between groups with different fatty acid ratios
- Study population included 264 pregnant people with HIV and their HIV-exposed uninfected children enrolled in the Pediatric HIV/AIDS Cohort Study Nutrition sub-study (2009-2011)
Limitations
This is an observational study measuring fatty acid levels at a single time point (third trimester), so it cannot establish causation or determine whether changing fatty acid ratios would prevent adverse outcomes. The study does not provide information about interventions to modify fatty acid intake or about outcomes in HIV-exposed infected children.
Abstract
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.