Table 4.
Multivariable association of analyte concentrations (optical density or concentration in quartiles) at 32 weeks gestation with stillbirth, low birthweight (LBW), small-for-gestational age (SGA), and preterm birth, among 706a women living with HIV in Dar es Salaam Tanzania.b
| Stillbirth |
LBW |
SGA |
Preterm birth |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Events, n | RR | 95% CI | p | Events, n | RR | 95% CI | p | Events, n | RR | 95% CI | p | Events, n | RR | 95% CI | p | |
| Biomarkers of EED | ||||||||||||||||
| Flagellin IgG (OD) | 0·55 | 0·86 | 0·48 | 0·58 | ||||||||||||
| 1 (0·087-1·385) | 5/177 | Ref | 11/172 | Ref | 35/172 | Ref | 23/172 | Ref | ||||||||
| 2 (1·387-1·748) | 10/176 | 1·91 | (0·69, 5·30) | 8/166 | 0·55 | (0·21, 1·42) | 22/166 | 0·59 | (0·35, 0·99) | 24/166 | 1·06 | (0·62, 1·83) | ||||
| 3 (1·751-2·126) | 9/176 | 1·74 | (0·62, 4·83) | 11/167 | 0·86 | (0·36, 2·05) | 35/167 | 1·04 | (0·68, 1·58) | 20/167 | 0·86 | (0·49, 1·52) | ||||
| 4 (2·128-3·336) | 8/176 | 1·51 | (0·48, 4·71) | 11/168 | 0·95 | (0·40, 2·25) | 35/168 | 1·04 | (0·68, 1·57) | 29/168 | 1·22 | (0·73, 2·03) | ||||
| Flagellin IgA (OD) | 0·17 | 0·63 | 0·52 | 0.24 | ||||||||||||
| 1 (0·040-1·114) | 7/177 | Ref | 5/170 | Ref | 30/170 | Ref | 18/170 | Ref | ||||||||
| 2 (1·121-1·604) | 6/176 | 0·78 | (0·26, 2·31) | 14/170 | 2·79 | (0·91, 8·53) | 31/170 | 1·08 | (0·68, 1·71) | 25/170 | 1·36 | (0·75, 2·46) | ||||
| 3 (1·607-2·092) | 6/176 | 0·84 | (0·29, 2·43) | 14/170 | 3·15 | (1·04, 9·52) | 31/170 | 1·05 | (0·66, 1·67) | 29/170 | 1·68 | (0·96, 2·95) | ||||
| 4 (2·097-3·259) | 13/176 | 1·67 | (0·70, 3·98) | 8/163 | 1·56 | (0·47, 5·18) | 35/163 | 1·17 | (0·75, 1·81) | 24/163 | 1·37 | (0·75, 2·51) | ||||
| LPS IgG (OD) | 0·26 | 0·55 | 0·71 | 0.27 | ||||||||||||
| 1 (0·089-1·328) | 7/177 | Ref | 13/170 | Ref | 35/170 | Ref | 21/170 | Ref | ||||||||
| 2 (1·329-1·802) | 12/176 | 1·30 | (0·53, 3·19) | 8/164 | 0·61 | (0·23, 1·60) | 27/164 | 0·83 | (0·52, 1·34) | 21/164 | 0·98 | (0·57, 1·71) | ||||
| 3 (1·803-2·342) | 6/176 | 0·65 | (0·23, 1·86) | 11/170 | 0·75 | (0·33, 1·71) | 30/170 | 0·85 | (0·54, 1·33) | 26/170 | 1·19 | (0·69, 2·04) | ||||
| 4 (2·346-3·367) | 7/176 | 0·71 | (0·24, 2·05) | 9/169 | 0·73 | (0·31, 1·72) | 35/169 | 1·08 | (0·71, 1·64) | 28/169 | 1·29 | (0·76, 2·21) | ||||
| LPS IgA(OD) | 0·07 | 0·60 | 0·41 | 0.51 | ||||||||||||
| 1 (0·017-1·005) | 4/177 | Ref | 9/173 | Ref | 35/173 | Ref | 18/173 | Ref | ||||||||
| 2 (1·010-1·465) | 8/176 | 2·19 | (0·67, 7·19) | 13/168 | 1·64 | (0·64, 4·19) | 27/168 | 0·80 | (0·51, 1·26) | 31/168 | 1·76 | (1·02, 3·04) | ||||
| 3 (1·468-2·054) | 9/176 | 2·16 | (0·69, 6·74) | 11/167 | 1·25 | (0·51, 3·06) | 26/167 | 0·77 | (0·48, 1·21) | 21/167 | 1·13 | (0·62, 2·05) | ||||
| 4 (2·054-3·441) | 11/176 | 2·83 | (0·92, 8·71) | 8/165 | 0·90 | (0·33, 2·46) | 39/165 | 1·16 | (0·78, 1·71) | 26/165 | 1·46 | (0·83, 2·59) | ||||
| sCD14 (ng/mL) | 0·68 | 0·29 | 0·58 | 0.91 | ||||||||||||
| 1 (16·770-2362·485) | 5/177 | Ref | 14/172 | Ref | 29/172 | Ref | 24/172 | Ref | ||||||||
| 2 (2365·170-3270.630) | 7/176 | 1·34 | (0·44, 4·09) | 10/169 | 0·87 | (0·37, 2·01) | 33/169 | 1·24 | (0·79, 1·96) | 20/169 | 0·83 | (0·48, 1·43) | ||||
| 3 (3271.670-5002.015) | 12/177 | 2·06 | (0·75, 5·60) | 8/165 | 0·56 | (0·22, 1·44) | 31/165 | 1·23 | (0·77, 1·96) | 28/165 | 1·14 | (0·70, 1·88) | ||||
| 4 (5005.980-19607·785) | 8/176 | 1·33 | (0·48, 3·70) | 9/168 | 0·63 | (0·26, 1·55) | 34/168 | 1·19 | (0·76, 1·87) | 24/168 | 0·92 | (0·55, 1·53) | ||||
| I-FABP (pg/mL) | 0·02 | 0·74 | 0·68 | 0.64 | ||||||||||||
| 1 (1·385-737.365) | 5/177 | Ref | 10/172 | Ref | 33/172 | Ref | 24/172 | Ref | ||||||||
| 2 (739.435-1346.800) | 5/176 | 1·06 | (0·32, 3·55) | 8/171 | 0·76 | (0·29, 2·00) | 33/171 | 1·03 | (0·66, 1·59) | 21/171 | 0·89 | (0·51, 1·54) | ||||
| 3 (1349.415- 2280.515) | 9/177 | 2·04 | (0·75, 5·56) | 13/168 | 1·34 | (0·55, 3·26) | 31/168 | 0·97 | (0·62, 1·51) | 25/168 | 1·03 | (0·61, 1·74) | ||||
| 4 (2280.515- 8338·955) | 13/176 | 2·44 | (1·00, 5·97) | 10/163 | 1·04 | (0·39, 2·80) | 30/163 | 0·93 | (0·60, 1·45) | 26/163 | 1·07 | (0·65, 1·76) | ||||
| Systemic inflammation | ||||||||||||||||
| AGP (g/L) | 0·11 | 0·88 | 0·03 | 0.57 | ||||||||||||
| 1 (0·180-0·680) | 7/180 | Ref | 9/173 | Ref | 26/173 | Ref | 26/173 | Ref | ||||||||
| 2 (0·685-0·920) | 4/173 | 0·58 | (0·17, 2·00) | 12/169 | 1·22 | (0·47, 3·20) | 31/169 | 1·31 | (0·81, 2·12) | 23/169 | 0·84 | (0·50, 1·41) | ||||
| 3 (0·925-1·295) | 7/178 | 0·88 | (0·34, 2·31) | 10/171 | 0·98 | (0·35, 2·78) | 29/171 | 1·17 | (0·72, 1·90) | 25/171 | 0·88 | (0·53, 1·46) | ||||
| 4 (1·300-8·040) | 14/175 | 1·63 | (0·66, 4·00) | 10/161 | 1·02 | (0·37, 2·79) | 41/161 | 1·69 | (1·07, 2·65) | 22/161 | 0·83 | (0·49, 1·40) | ||||
| CRP (mg/L) | 0·20 | 0·67 | 0·25 | 0.73 | ||||||||||||
| 1 (0·245-5·115) | 4/177 | Ref | 13/173 | Ref | 35/173 | Ref | 25/173 | Ref | ||||||||
| 2 (5·150-11·460) | 7/176 | 1·40 | (0·39, 5·01) | 7/169 | 0·61 | (0·23, 1·63) | 25/169 | 0·76 | (0·47, 1·22) | 26/169 | 1·15 | (0·70, 1·91) | ||||
| 3 (11·480- 20·910) | 10/177 | 1·84 | (0·62, 5·40) | 12/167 | 0·94 | (0·42, 2·12) | 29/167 | 0·89 | (0·56, 1·40) | 19/167 | 0·84 | (0·48, 1·49) | ||||
| 4 (20·915-115·020) | 11/176 | 2·03 | (0·67, 6·13) | 9/165 | 0·72 | (0·29, 1·80) | 38/165 | 1·14 | (0·75, 1·71) | 26/165 | 1·15 | (0·69, 1·90) | ||||
| Growth hormone axis | ||||||||||||||||
| IGF-1 (ng/mL) | 0·08 | 0·44 | 0·14 | 0.75 | ||||||||||||
| 1 (0·375-95·535) | 10/177 | Ref | 12/167 | Ref | 40/167 | Ref | 23/167 | Ref | ||||||||
| 2 (96.445-170.920) | 7/176 | 0·67 | (0·26, 1·69) | 11/169 | 0·85 | (0·36, 2·04) | 27/169 | 0·65 | (0·42, 1·02) | 26/169 | 1·14 | (0·68, 1·92) | ||||
| 3 (171·065-253.650) | 11/177 | 1·06 | (0·47, 2·40) | 8/166 | 0·62 | (0·23, 1·67) | 34/166 | 0·88 | (0·58, 1·34) | 18/166 | 0·83 | (0·47, 1·45) | ||||
| 4 (253.985-1144.363) | 4/176 | 0·30 | (0·08, 1·08) | 10/172 | 0·69 | (0·24, 1·97) | 26/172 | 0·64 | (0·40, 1·00) | 29/172 | 1·20 | (0·72, 2·00) | ||||
| FGF21 (pg/mL) | 0·22 | 0·87 | 0·10 | 0.02 | ||||||||||||
| 1 (0·465-245·185) | 5/177 | Ref | 9/172 | Ref | 28/172 | Ref | 19/172 | Ref | ||||||||
| 2 (246·975-575·790) | 9/176 | 2·20 | (0·83, 5·87) | 11/167 | 1·22 | (0·51, 2·91) | 29/167 | 1·09 | (0·68, 1·73) | 19/167 | 1·04 | (0·57, 1·90) | ||||
| 3 (576·350-1465·635) | 8/177 | 1·59 | (0·59, 4·29) | 10/169 | 1·02 | (0·39, 2·65) | 33/169 | 1·20 | (0·76, 1·89) | 23/169 | 1·20 | (0·68, 2·11) | ||||
| 4 (1468·845-9228.637) | 10/176 | 2·26 | (0·89, 5·75) | 11/166 | 1·15 | (0·44, 2·97) | 37/166 | 1·42 | (0·91, 2·22) | 35/166 | 1·77 | (1·04, 3·00) | ||||
a
N=706 women for stillbirth outcome; N=674 women for livebirth outcomes (low birthweight [LBW], small-for-gestational age [SGA], and preterm birth).
b
Models adjusted for age, BMI, marital status, maternal education, parity, SES, clinic site, WHO HIV stage, CD4 T-cell count, timing of ART initiation, infant sex, and parent trial regimen. The p-values were calculated from log binomial models. OD, optical density; IgA, immunoglobulin A; IgG, immunoglobulin G; LPS, lipopolysaccharide; sCD14, soluble CD14; I-FABP, intestinal fatty acid-binding protein; CRP, C-reactive protein; AGP, α1-acid glycoprotein; IGF-1, insulin-like growth factor 1; FGF21, fibroblast growth factor 21 (FGF21); ng, nanograms; pg, picograms; mg, milligrams; mL, milliliters; L, liters.