TABLE 4.
Association of DDS with birth outcomes in HIV-negative women in Tanzania1
| Clinical outcome | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | P-trend |
|---|---|---|---|---|---|---|
| DDS median (IQR) | 2.0 (2.0–2.3) | 2.5 (2.5–2.7) | 3.0 (3.0–3.0) | 3.5 (3.3–3.5) | 4.0 (4.0–4.5) | |
| Preterm birth2 (<37 weeks of gestation) | ||||||
| n | 252/1550 | 201/1428 | 344/1765 | 149/1362 | 206/1448 | |
| Univariate | Ref | 0.87 (0.73, 1.03) | 1.20 (1.03, 1.39)* | 0.67 (0.56, 0.81)*** | 0.88 (0.74, 1.04) | |
| Multivariate, energy, BMI, and anemia adjusted3 | 0.87 (0.74, 1.04) | 1.24 (1.06, 1.44)* | 0.72 (0.60, 0.88)** | 0.97 (0.82, 1.16) | 0.22 | |
| Small for gestational age4 (<10th percentile for gestational age/sex) | ||||||
| n | 245/1400 | 231/1284 | 266/1601 | 207/1221 | 171/1318 | |
| Univariate | 1.03 (0.87, 1.21) | 0.95 (0.81, 1.11) | 0.97 (0.82, 1.15) | 0.74 (0.62, 0.89)** | ||
| Multivariate, energy, BMI, and anemia adjusted3 | 1.01 (0.86, 1.19) | 0.95 (0.81, 1.11) | 0.97 (0.82, 1.15) | 0.74 (0.62, 0.89)** | <0.01** | |
| Low birth weight5 (<2500 g) | ||||||
| n | 114/1458 | 71/1359 | 107/1641 | 71/1287 | 85/1373 | |
| Univariate | 0.67 (0.50, 0.89)* | 0.83 (0.65, 1.08) | 0.71 (0.52, 0.94)* | 0.79 (0.60, 1.04) | ||
| Multivariate, energy, BMI, and anemia adjusted3 | 0.66 (0.50, 0.88)** | 0.84 (0.65, 1.08) | 0.70 (0.53, 0.94)* | 0.80 (0.61, 1.04) | 0.11 | |
| Fetal loss6 (spontaneous abortion, stillbirth) | ||||||
| n | 46/1550 | 34/1428 | 72/1765 | 41/1362 | 45/1448 | |
| Univariate | 0.80 (0.51, 1.24) | 1.37 (0.96, 1.98) | 1.01 (0.67, 1.53) | 1.05 (0.70, 1.57) | ||
| Multivariate, energy, BMI, and anemia adjusted3 | 0.73 (0.46, 1.15) | 1.37 (0.95, 1.98) | 0.90 (0.58, 1.40) | 0.95 (0.62, 1.45) | 0.96 |
Values are RR (95% CI) unless otherwise noted. RR and 95% CI are for more diversified diets. Dietary diversity was assessed as quintiles of mean dietary diversity throughout pregnancy. Test for trend was conducted using median DDS for diet quintiles. *P < 0.05, ** P< 0.01,***P <0.001. DDS, dietary diversity score.
Multivariate models for preterm birth adjust for multivitamin group assignment (placebo/multivitamin), child sex (male/female) low food expenditure (yes/no), married (yes/no), wealth index above median (yes/no), maternal age (<30, 30–39, >40 y), and maternal education (no/primary, secondary, tertiary).
Energy, BMI, and anemia adjusted models adjust for BMI (<18.5, 18.5–24.99, 25.0–29.9, >30), anemia status at randomization in the main trial (none, moderate, severe), and energy using restricted cubic splines in addition to covariates controlled for in multivariate models.
Multivariate models for small for gestational age adjust for multivitamin group assignment (placebo/multivitamin), low food expenditure (yes/no), wealth index above median (yes/no), maternal age (<30, 30–39, >40 y), parity (0, 1–2, ≥3 children), child sex (male/female), and maternal shortness (height <145 cm).
Multivariate models for low birth weight adjust for multivitamin group assignment (placebo/multivitamin), history of fetal loss (yes/no), married (yes/no), parity (0, 1–2, ≥3children), child sex (male/female), wealth index above median(yes/no), maternal age (<30, 30–39, >40 y), and maternal shortness (height <145 cm).
Multivariate models for fetal loss adjust for multivitamin group assignment (placebo/multivitamin), low food expenditure (yes/no), parity (0, 1–2, ≥3 children), history of fetal loss at first pregnancy (yes/no), married (yes/no), and maternal height.