TABLE 3.
Association between 25(OH)D concentration and physician diagnosis of selected morbidities and incident anthropometric and anemia outcomes among HIV-exposed, uninfected infants1
| 25(OH)D <10 ng/mL |
25(OH)D 10–19.9 ng/mL |
25(OH)D ≥30 ng/mL |
|||||
| Value | P | Value | P | 25(OH)D 20-29.9 ng/mL (reference) | Value | P | |
| Diarrhea | |||||||
| Mean diagnoses/y | 2.92 | 2.98 | 2.91 | 2.81 | |||
| Crude IRR (95% CI) | 1.26 (0.99, 1.60) | 0.06 | 1.03 (0.83, 1.29) | 0.76 | 1.0 | 1.04 (0.75, 1.44) | 0.81 |
| Adjusted IRR2 (95% CI) | 1.04 (0.81, 1.33) | 0.75 | 0.95 (0.76, 1.19) | 0.68 | 1.0 | 1.10 (0.80, 1.52) | 0.56 |
| Acute lower respiratory infection | |||||||
| Mean diagnoses/y | 0.66 | 0.61 | 0.72 | 0.73 | |||
| Crude IRR (95% CI) | 0.92 (0.71, 1.19) | 0.53 | 0.85 (0.68, 1.07) | 0.18 | 1.0 | 1.01 (0.73, 1.39) | 0.95 |
| Adjusted IRR2 (95% CI) | 0.95 (0.73, 1.24) | 0.71 | 0.90 (0.71, 1.13) | 0.36 | 1.0 | 1.08 (0.77, 1.50) | 0.66 |
| Clinical malaria | |||||||
| Mean diagnoses/y | 1.88 | 1.96 | 1.90 | 2.60 | |||
| Crude IRR (95% CI) | 1.00 (0.81, 1.23) | 0.98 | 1.04 (0.87, 1.25) | 0.63 | 1.0 | 1.37 (1.09, 1.73) | <0.01 |
| Adjusted IRR2 (95% CI) | 1.12 (0.90, 1.38) | 0.30 | 1.11 (0.93, 1.32) | 0.27 | 1.0 | 1.34 (1.06, 1.70) | 0.02 |
| Confirmed malaria | |||||||
| Mean diagnoses/y | 0.24 | 0.28 | 0.28 | 0.43 | |||
| Crude IRR (95% CI) | 0.87 (0.60, 1.26) | 0.45 | 1.00 (0.73, 1.37) | 0.99 | 1.0 | 1.55 (1.05, 2.29) | 0.03 |
| Adjusted IRR2 (95% CI) | 0.96 (0.66, 1.40) | 0.83 | 1.10 (0.80, 1.49) | 0.56 | 1.0 | 1.71 (1.15, 2.54) | <0.01 |
| Oral candidiasis | |||||||
| Mean diagnoses/y | 0.20 | 0.16 | 0.13 | 0.06 | |||
| Crude IRR (95% CI) | 1.55 (1.08, 2.24) | 0.02 | 1.25 (0.89, 1.76) | 0.20 | 1.0 | 0.48 (0.24, 0.98) | 0.04 |
| Adjusted IRR2 (95% CI) | 1.47 (1.00, 2.15) | 0.046 | 1.28 (0.90, 1.81) | 0.17 | 1.0 | 0.61 (0.31, 1.22) | 0.16 |
| Stunting (LAZ <−2) | |||||||
| % (number of events/infants) | 29.0 (56/193) | 26.1 (87/334) | 28.2 (70/248) | 35.7 (35/98) | |||
| Crude HR (95% CI) | 1.10 (0.77, 1.56) | 0.61 | 0.98 (0.71, 1.34) | 0.89 | 1.0 | 1.43 (0.95, 2.14) | 0.09 |
| Adjusted HR2 (95% CI) | 1.22 (0.84, 1.77) | 0.31 | 0.99 (0.71, 1.37) | 0.94 | 1.0 | 1.19 (0.78, 1.82) | 0.42 |
| Wasting (WLZ <−2) | |||||||
| % (number of events/infants) | 37.6 (74/197) | 29.5 (96/325) | 26.9 (65/242) | 33.3 (33/99) | |||
| Crude HR (95% CI) | 1.51 (1.08, 2.11) | 0.02 | 1.14 (0.83, 1.56) | 0.43 | 1.0 | 1.29 (0.85, 1.96) | 0.23 |
| Adjusted HR2 (95% CI) | 1.71 (1.20, 2.43) | <0.01 | 1.19 (0.86, 1.64) | 0.30 | 1.0 | 1.12 (0.72, 1.73) | 0.62 |
| Underweight (WAZ <−2) | |||||||
| % (number of events/infants) | 29.0 (55/190) | 25.5 (85/333) | 27.2 (68/250) | 25.0 (24/96) | |||
| Crude HR (95% CI) | 1.06 (0.74, 1.52) | 0.74 | 0.95 (0.69, 1.30) | 0.74 | 1.0 | 0.93 (0.58, 1.48) | 0.75 |
| Adjusted HR2 (95% CI) | 1.20 (0.82, 1.74) | 0.35 | 1.00 (0.72, 1.39) | 0.99 | 1.0 | 0.79 (0.49, 1.28) | 0.34 |
| Severe anemia (<8.5 g/dL) | |||||||
| % (number of events/infants) | 24.9 (48/193) | 20.4 (66/324) | 20.1 (48/239) | 25.9 (22/85) | |||
| Crude HR (95% CI) | 1.28 (0.86, 1.90) | 0.23 | 1.01 (0.69, 1.46) | 0.97 | 1.0 | 1.35 (0.81, 2.23) | 0.25 |
| Adjusted HR2 (95% CI) | 1.44 (0.92, 2.26) | 0.12 | 1.08 (0.72, 1.62) | 0.71 | 1.0 | 1.23 (0.69, 2.17) | 0.49 |
n = 948. IRR, incidence rate ratio; LAZ, length-for-age z score; WAZ, weight-for-age z score; WLZ, weight-for-length z-score; 25(OH)D, 25-hydroxyvitamin D.
Adjusted for baseline maternal factors, including age, education, marital status, number of prior pregnancies, household assets, food expenditure per person, underweight, anemia, CD4 T-cell count, and use of antiretrovirals during pregnancy, and baseline child factors, including sex, exclusive breastfeeding, stunting, wasting, low birth weight, anemia, season of 25(OH)D measurement, and randomized treatment regimen. Baseline child anemia (<10 g/dL) adjusted for in anthropometric analysis and stunting and wasting adjusted for in anemia analysis.