Faculty Bibliography

In 2018, the American Academy of Pediatrics warned consumers over the increasing use of imported infant formulas. The purpose of this study was to assess the usage of imported European infant formula among parents in a large urban private practice. An anonymous survey was distributed at well-child appointments to a convenience sample of parents at an urban private pediatric practice from November 2017 to March 2018. Of the 750 eligible respondents, 552 (74%) completed the survey. Of the parents using formula, 20% were using imported European infant formulas. The most commonly used formula was Holle (33%), and 72% were acquired from web-based third-party vendors. Parents chose to use these formulas because they believed that European formulas contained better ingredients. Only 8% of parents received information about European infant formula from their pediatricians. Pediatricians need to be aware of these formulas and their risks to educate families on the use and safety of these formulas.

BACKGROUND: Proteinuria during pregnancy has been associated with increased pregnancy complications. Furthermore, even low-grade proteinuria has been associated with increased mortality in the general population and in non-pregnant HIV-infected women. METHODS: Urine dipstick protein was measured prospectively on HIV-infected and trace protein or more and quantified by urine protein:creatinine measurement (P:C). Logistic regression modeling was used to identify factors associated with proteinuria. RESULTS: About 199 human immunodeficiency virus (HIV)-infected and 190 HIV-uninfected normotensive pregnant women were evaluated. The median age was 27 years in both groups and 37% presented in the third trimester. Among HIV-infected women, median CD4 cell count was 417 cells/mm(3); 27% were on combination antiretroviral therapy (cART). Proteinuria was present in 39.2% of HIV-infected and 20.9% of uninfected women (P < 0.001). HIV infection was independently associated with proteinuria [adjusted odds ratio (OR) = 2.45; confidence interval (CI) = 1.56-3.85]. Among HIV-infected pregnant women, cART was protective (adjusted OR = 0.39; CI = 0.19-0.82). Results were qualitatively similar when urine P:C was evaluated as a continuous outcome variable. CONCLUSIONS: The prevalence of low-grade proteinuria in both HIV-infected and -uninfected Cameroonian pregnant women is high. HIV-infected pregnant women are at increased risk for proteinuria, and cART appears to exert a protective effect. Further studies are needed to elucidate the causes of increased proteinuria in African pregnant women, both HIV-infected and -uninfected.