Association between maternal HIV infection and low birth weight and prematurity: a meta-analysis of cohort studies

Abstract

BackgroundTo assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women.MethodsSeveral English and Chinese databases were searched (updated to May 2015) to find the studies reporting infant outcomes associated with exposure to maternal HIV infection during pregnancy. Relevant articles were manually selected based on several inclusion and exclusion criteria.ResultsFifty-two cohort studies including 15,538 (for LBW) and 200,896 (for PTD) HIV infected women met the inclusion criteria. There was significant heterogeneity among studies for maternal HIV infection associated with LBW/PTD (I2 = 71.7 %, P < 0.05, and I2 = 51.8 %, P < 0.05 for LBW and PTD, respectively). The meta-analysis demonstrated that the maternal HIV infection was significantly associated with both LBW (pooled odds ratio (OR): 1.73, 95 % confidence interval (CI): 1.64, 1.82, P < 0.001) and PTD (pooled OR: 1.56, 95 % CI: 1.49, 1.63, P < 0.001). No significant difference in the relationship between maternal HIV infection and adverse pregnancy outcomes was detected among the groups of different study periods. HIV infected women were at slightly higher risk of LBW in developing countries compared with women in developed countries (OR: 2.12 (95 % CI: 1.81, 2.48) vs. 1.75 (95 % CI: 1.44, 2.12)). Antiretroviral drugs usage did not significantly change the associations of maternal HIV exposure with LBW and PTD.ConclusionsHIV infected women were at higher risk of having a low birth weight infant or a preterm delivery infant compared with uninfected women. Such associations did not change significantly over time or were not significantly affected by the usage of antiretroviral drugs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0684-z) contains supplementary material, which is available to authorized users.

Factors associated with delivering premature and/or low birth weight infants among pregnant HIV-positive women on antiretroviral treatment at Dr George Mukhari Hospital, South Africa

“…16 Interestingly, Xiao and co-workers, in their meta-analysis, found that ARV drug usage did not significantly change the association of maternal HIV exposure to ARV drugs with LBW. 11 In contrast, one study in South Africa found that HIV-positive mothers not on ART or ARV prophylaxis delivered significantly LBW infants compared with the HIV-positive mothers on ART or ARV prophylaxis. 17 It is worth noting that, in our study, HIV-positive women not on ART or ARV prophylaxis significantly delivered babies with birthweight < 1 000 g. The findings in our study could be due to the fact that the HIV-positive mothers not on ART might have had a lower CD4 cell count and higher HIV RNA viral load, which might have contributed to extremely LBW (< 1 000 g) babies.…”

Tenofovir exposure in utero and linear growth in HIV-exposed, uninfected infants

“…Nonetheless, maternal HIV infection is a known risk factor for preterm delivery, which in turn substantially increases the risk of child mortality and morbidity including suboptimal growth. [22, 23] As such, identifying and providing appropriate care to premature infants should be integral to strategies aimed at optimizing HEU child health.…”

Feto-maternal outcome in human immunodeficiency virus seropositive mothers in co-relation with CD4 count

“…10 Brocklehurst et al and Xiao PL reported that LBW and PTD were associated with maternal HIV infection. 11,12 Habib et al, has also shown an association between maternal HIV status and preterm labour. 13 19,20 There was an increased incidence of adverse foetal outcomes in terms of IUD, still birth and preterm birth -20% in HIV seropositive patients in contrast to 2.5% in HIV seronegative pregnancies.…”