The triple burden of obesity, HIV, and anaemia during pregnancy and associations with delivery outcomes in urban South Africans
Bibliographic record
Abstract
Objectives First, to explore the independent associations between obesity, HIV (with ARV treatment), and anaemia and delivery outcomes in urban South African women and, second, to identify any potential interactions between these co-morbidities.Design Longitudinal observational cohort study.Setting Soweto, South Africa.Subjects Mother–infant pairs (789) were recruited when mothers were < 20 weeks pregnant.Outcome measures Infant gestational age at delivery was calculated, and infant birth weight and length were measured by trained research nurses. Head circumference was measured using a metal head circumference tape measure. Multivariable linear regression and logistic regression models were used to test the associations between obesity, HIV-positive status, and anaemia and delivery outcomes, as well as the potential interactions between the triple burden exposures.Results At baseline, 14%, 11%, and 22% of women were diagnosed with only obesity, HIV, or anaemia respectively, while 42% had two conditions and 5% were exposed to the triple burden. Maternal obese vs. non-obese status was associated with a 0.32 higher weight-to-length z-score at birth (p < 0.01) and a 2.93 times higher risk of a large-for-gestational age delivery (p < 0.01). There were no interactions between the triple burden exposures on delivery outcomes.Conclusions This study presents evidence for the importance of prioritising obesity prevention prior to conception in urban African settings such as South Africa. In addition, our findings highlight the need for more research into the complex relationships between maternal co-morbidities, as well as their potential influence (alone and in combination) on maternal and offspring health in the short and longer term.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".