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Trends in birth weight and gestational age for infants born to HIV-infected, antiretroviral treatment-naive women in Malawi.

ABSTRACT: We analyzed birth outcomes among infants of treatment-naive, HIV-infected women from a series of mother-to-child transmission of HIV studies in Blantyre, Malawi.Data from 6 prospective studies at 1 research site were analyzed. Mean birth weight (BW) and gestational age (GA), and frequency of low birth weight (LBW; <2500 g) and preterm (PT) birth (GA < 37 weeks) were estimated. We assessed risk factors for LBW and PT birth using mixed-effects logistic regression. Adjusted odds ratios (AOR) and 95% confidence intervals from earlier studies (1989-1994) and later studies (2000-2007) are presented separately.The analysis included 8874 HIV-exposed infants. Mean BW and GA ranged from 2793 to 3079 g, and from 37.8 to 39.0 weeks. Greater maternal age was consistently (during both the early and late periods) associated with lower odds of LBW and PT birth; AOR (95% confidence intervals) for both outcomes in the early and late periods, respectively, were 0.98 (0.96-1.00) and 0.97 (0.95-0.99). Female infant gender was consistently associated with higher odds of PT birth during both periods and with higher odds of LBW during the later period. During the early period, higher maternal education was associated with lower odds of LBW (AOR 0.67 [0.48-0.95]) and PT birth (AOR 0.70 [0.51-0.95]), and later birth year was associated with lower odds of PT birth (AOR 0.35 [0.19-0.70]).BW and GA remained stable within each time period. This analysis provides important baseline information for monitoring HIV treatment effects on birth outcomes. Modifiable factors affecting BW and GA should continue to be explored.

SUBMITTER: Taha TE

PROVIDER: S-EPMC3329585 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Trends in birth weight and gestational age for infants born to HIV-infected, antiretroviral treatment-naive women in Malawi.

Taha Taha E TE Dadabhai Sufia S SS Rahman M Hafizur MH Sun Jin J Kumwenda Johnstone J Kumwenda Newton I NI

The Pediatric infectious disease journal 20120501 5

<h4>Background</h4>We analyzed birth outcomes among infants of treatment-naive, HIV-infected women from a series of mother-to-child transmission of HIV studies in Blantyre, Malawi.<h4>Methods</h4>Data from 6 prospective studies at 1 research site were analyzed. Mean birth weight (BW) and gestational age (GA), and frequency of low birth weight (LBW; <2500 g) and preterm (PT) birth (GA < 37 weeks) were estimated. We assessed risk factors for LBW and PT birth using mixed-effects logistic regression ...[more]

PMID: 22327871

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Project description:Strabismus causes irreversible vision loss if not detected and treated early. It is unclear whether birth weight (BW) and gestational age (GA) are risk factors for strabismus.To estimate the effect of BW and GA on the likelihood of premature infants developing strabismus.In this longitudinal cohort analysis, we monitored a group of premature children from birth to determine the proportion that developed strabismus and the timing of the first strabismus diagnosis. Multivariable Cox regression analyses assessed the relationships of BW and GA with the development of strabismus. Regression models were adjusted for other risk factors for strabismus, sociodemographic factors, and ocular comorbidities. The analysis included 38,055 otherwise healthy children born prematurely who were enrolled for more than 6 months in a nationwide US managed care network between 2001 and 2011 in communities throughout the United States.Birth weight less than 2000 g or GA of 32 weeks or less.Hazard ratios (HRs) for strabismus with 95% CIs.Of 38,055 otherwise healthy children who were born prematurely, 583 received a diagnosis of strabismus later in life. The cumulative incidence of strabismus was 3.0% at 5 years. Controlling for GA and other covariates, infants born with BW less than 2000 g had a 61% increased hazard (HR, 1.61; 95% CI, 1.22-2.13) of developing strabismus. Controlling for BW and other covariates, there was no significant association between strabismus and GA (HR, 0.98; 95% CI, 0.69-1.38). Among premature infants with BW of less than 2000 g, a GA of 32 weeks or less conveyed no additional increased risk for developing strabismus relative to infants born after 32 weeks (HR, 1.27; 95% CI, 0.86-1.88). In contrast, among infants with a GA of 32 weeks or less, BW of less than 2000 g conveyed a 14-fold increase in the risk of strabismus relative to BW of 2000 g or more (HR, 14.39; 95% CI, 1.99-104.14).Independent of GA, very low BW conferred a large increase in strabismus risk among premature infants. In contrast, independent of BW, GA did not significantly affect the risk of strabismus. Updates to existing guidelines in the pediatric and ophthalmic literature should be considered, highlighting the importance of BW rather than GA and alerting clinicians about the need for careful monitoring of premature infants with low BW for strabismus.

Dataset Information

Trends in birth weight and gestational age for infants born to HIV-infected, antiretroviral treatment-naive women in Malawi.

Publications

Trends in birth weight and gestational age for infants born to HIV-infected, antiretroviral treatment-naive women in Malawi.

Similar Datasets

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