Trial reportMaternal and child health journal2025
Mid-Trimester Allostatic Load and Spontaneous Preterm Birth in a Cohort of Pregnant Women Living with HIV in Zambia.
Trial report in Maternal and child health journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesMaternal HIV is associated with preterm birth (PTB). In resource-rich settings, spontaneous preterm birth (SPTB) has been linked to biomarkers of stress. We examined the association between allostatic load and SPTB among women with HIV.
methodsIn a nested case-cohort analysis of a randomized trial of intramuscular progesterone to prevent PTB in women with HIV in Lusaka, Zambia, we measured 15 midtrimester plasma biomarkers from 4 domains: cardiovascular, immune, metabolic, and neuroendocrine. SPTB was defined as delivery <37wks preceded by spontaneous labor or membrane rupture. A composite ALI was calculated by summing Z-scores from all markers (ALI-15); another was calculated from a 7 marker subset (ALI-7) with Z-score differences >0.1 between outcome groups. We estimated SPTB time-to-event curves and hazard ratios (HR) between ALI quartiles.
resultsOf 800 women enrolled in IPOP (2015-2017), 51 (6%) had SPTB. We randomly selected 107 participants, including 6 with SPTB (cases). We then selected all remaining cases (n=45), yielding a final sample of 152. Z-score distributions of systolic blood pressure, heart rate, HDL, triglycerides, hemoglobin A1C, albumin, and 25-OH Vitamin D were included in ALI-7. Participants in the fourth quartile of ALI-7 were more likely to experience SPTB (HR 2.49, 95% CI 1.15-5.40) than participants in the second quartile; this association was attenuated when quartile groups were defined by ALI-15 (HR 1.24, 95% CI 0.59-2.60).
conclusionsHigh ALI among women with HIV was associated with SPTB. A seven marker ALI appeared a more meaningful indicator of risk than one composed of all measured markers.
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