Evidence map›Paper›PMID 38965743›Full record

ArticleAmerican journal of epidemiology2025

How much could anemia-related interventions reduce the HIV disparity in adverse birth outcomes?

Ellen C Caniglia, Rebecca Zash, Modiegi Diseko, Gloria Mayondi, Judith Mabuta, Mompati Mmalane, Joseph Makhema, Denise L Jacobson, Angela M Bengtson, Shahin Lockman and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ellen C CanigliaDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
Rebecca ZashBotswana Harvard Health Partnership, Gaborone, Botswana.
Modiegi DisekoBotswana Harvard Health Partnership, Gaborone, Botswana.
Gloria MayondiBotswana Harvard Health Partnership, Gaborone, Botswana.
Judith MabutaBotswana Harvard Health Partnership, Gaborone, Botswana.
Mompati MmalaneBotswana Harvard Health Partnership, Gaborone, Botswana.
Joseph MakhemaBotswana Harvard Health Partnership, Gaborone, Botswana.
Denise L JacobsonHarvard T.H. Chan School of Public Health, Boston, USA.
Angela M BengtsonDepartment of Epidemiology, Emory University School of Public Health, Atlanta, USA.
Shahin LockmanBotswana Harvard Health Partnership, Gaborone, Botswana.
Roger ShapiroBotswana Harvard Health Partnership, Gaborone, Botswana.
Sonja A SwansonDepartment of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, USA.

Funding

Tsepamo Plus: Expanded Congenital Abnormalities Surveillance with an Emulated Clinical Trial to Evaluate Weight Impact on Birth Outcomes for Newer ART RegimensP01HD107670 · NICHD · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2021 to 2025
$6.1M
Botswana Birth Outcomes Surveillance ExtensionR01HD095766 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2018 to 2022
$3.3M
Birth Outcomes Surveillance in BotswanaR01HD080471 · NICHD · HARVARD SCHOOL OF PUBLIC HEALTH · PI SHAPIRO, ROGER L · 2014 to 2018
$2.6M
Mentoring in Patient-Oriented HIV Research in the Era of Universal ARTK24AI131928 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI SHAHIN LOCKMAN · 2017 to 2026
$1.9M
Decreasing Adverse Birth Outcomes among HIV-infected Women on Antiretroviral TherapyK23HD088230 · NICHD · BETH ISRAEL DEACONESS MEDICAL CENTER · PI ZASH, REBECCA MARIE · 2017 to 2021
$820k
Iron and folic acid supplementation strategies during pregnancy and adverse pregnancy outcomes in Botswana - Resubmission - 1K01HD100222 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI CANIGLIA, ELLEN CHRISTINA · 2020 to 2024
$632k
NIAID NIH HHS K24 AI131928NICHD NIH HHS K01 HD100222NICHD NIH HHS K23 HD088230NICHD NIH HHS P01 HD107670NICHD NIH HHS R01 HD080471NICHD NIH HHS R01 HD095766
6 · The paper itself

Abstract

Women and other people of childbearing potential living with HIV (WLHIV) have a higher risk of adverse birth outcomes than those without HIV (WWHIV). A higher risk of anemia in WLHIV could partially explain this disparity. Using a birth outcomes surveillance study in Botswana, we emulated target trials corresponding to currently available or feasible interventions on anemia. The first target trial evaluated 2 interventions: initiate multiple micronutrient supplementation (MMS), and MMS or iron and folic acid supplementation by 24 weeks gestation. The remaining target trials evaluated the interventions: eliminate anemia before pregnancy; and jointly eliminate anemia before pregnancy and initiate MMS. We estimated the observed disparity in adverse birth outcomes between WLHIV and WWHIV and compared the observed disparity measure (ODM) to the counterfactual disparity measure (CDM) under each intervention. Of 137 499 individuals (22% WLHIV), the observed risk of any adverse birth outcome was 26.0% in WWHIV and 34.5% in WLHIV (ODM, 8.5%; 95% confidence interval [CI], 7.9-9.1%). Counterfactual disparity measures (95% CIs) ranged from 6.6% (4.8-8.4%) for the intervention to eliminate anemia and initiate MMS to 8.4% (7.7%-9.1%) for the intervention to eliminate anemia only. Preventing anemia and expanding MMS may reduce HIV disparities in birth outcomes, but interventions with greater impact should be identified.

Indexed as

AnemiaHealth Status DisparitiesHIV InfectionsPregnancy Complications, InfectiousPregnancy OutcomeAdultBotswanaDietary SupplementsFemaleFolic AcidHumansIronPregnancyYoung AdultFolic AcidIronadverse birth outcomesdisparitiesHIVtarget trial emulation

Identifiers

PMID38965743
PMCPMC11735963

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.