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

Gibango, N. N.; Mda, Siyazi; Ntuli, TS

doi:10.1080/23120053.2017.1382167

Cited by 6 publications

(13 citation statements)

References 18 publications

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“…Consistent with previous results [8,18,51], the study has also shown that perinatal mortality was higher among infants of HIVinfected mothers compared to those of HIV-uninfected mothers. These findings are in line with studies that have reported that LBW and perinatal mortality are inter-related and that LBW accounts for the majority of perinatal deaths [18,51]. Since low birth weight was high among infants of HIV-infected mothers, we postulate that most of them did not survive after the first week from birth.…”

Section: Discussionsupporting

confidence: 92%

“…This has been attributed to the fact that HIV-infected women not on treatment have suppressed immune system which may have affected child growth and contributed to LBW among their infants [1,4,18]. Consistent with previous results [8,18,51], the study has also shown that perinatal mortality was higher among infants of HIVinfected mothers compared to those of HIV-uninfected mothers. These findings are in line with studies that have reported that LBW and perinatal mortality are inter-related and that LBW accounts for the majority of perinatal deaths [18,51].…”

Section: Discussionsupporting

confidence: 89%

“…A growing number of studies have shown conflicting evidence on the association between maternal HIV and adverse pregnancy outcomes such as LBW. Some studies have shown that antiretroviral therapy (ART) among HIV-infected mothers is associated with adverse outcomes such as low birth weight (LBW), intrauterine growth restriction (IUGR), preterm delivery (PTD) and stillbirths [14][15][16][17][18]. On the other hand, several studies have found that sustained intake of ART among HIVinfected mothers reduces adverse pregnancy outcomes such as stillbirths, low birth weight and prematurity [16,19].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Effects of Maternal HIV Infection on Pregnancy Outcomes using Cross-sectional Data in Malawi

Twabi

Manda

Small

2020

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Background : Several studies have shown that maternal HIV infection is associated with adverse pregnancy outcomes such as low birth weight and perinatal mortality. However, the association is conflicted with the effect of antiretroviral therapy (ART) on the pregnancy outcomes and it remains unexamined. Using methods for matching possible confounders, the objectives of the study were to assess the effect of maternal HIV on birth weight and perinatal mortality and to investigate the effect of ART on these two pregnancy outcomes in HIV-infected women. Methods: Data on 4111 and 4759 children, born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys (MDHS) respectively, whose mothers had an HIV test result, were analysed. A best balancing method was chosen from a set of covariate balance methods namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting on the PS. HIV and ART data were only available in the MDHS 2010, permitting an assessment of the moderating effect of ART on the association between maternal HIV infection and birth weight and perinatal mortality. Results: In 2010, maternal HIV infection was negatively associated with birth weight (-25.3g, 95% CI:(-95.5, -7.4)) and in 2015-16 it was positively associated with birth weight (116.3g, 95 % CI:(27.8, 204.7)). Perinatal mortality was higher in infants of HIV-infected mothers compared to infants of HIV-uninfected mothers (OR = 1.5, 95% CI:(1.1 - 3.1)) in 2010, while there was no difference in the rate in 2015-16 (OR = 1.0, 95% CI:(0.4, 1.6)). ART was not associated with birth weight, however, it was associated with perinatal mortality (OR=3.9, 95% CI:(1.1, 14.8)). Conclusion: The study has found that maternal HIV infection had an adverse effect on birth weight and perinatal mortality in 2010. Birth weight was not dependent on ART uptake but perinatal mortality was higher among infants of HIV-infected mothers who were not on ART. The higher birth weight among HIV-infected mothers and similarity in perinatal mortality with HIV-uninfected mothers in 2015-16 may be indicative of successes of interventions within the PMTCT program in Malawi.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing the Effects of Maternal HIV Infection on Pregnancy Outcomes using Cross-sectional Data in Malawi

Twabi

Manda

Small

2020

Preprint

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“…However, they advised caution when deciding to administer a combination of ART drugs. Gibango et al, [17] found that HIV-positive mothers not on ART were likely to deliver an infant with low birth weight. While, Marazzi et al, [7] in their retrospective cohort study done in Malawi and Mozambique and Sazyld et al, [6], found that low birth weight was not associated with ART duration and concluded that ART actually led to a reduction in adverse pregnancy outcomes such as low birth weight.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have claimed that ART among HIV-infected mothers is associated with adverse outcomes such as low birth weight (LBW), intrauterine growth restriction (IUGR), preterm delivery (PTD) and stillbirths [5,6,7,8]. While some studies have revealed that HIV-infected mothers not on ART were likely to have infants with low birth weight [17]. [c18] In addition, other studies have attributed these adverse outcomes to maternal HIV infection [18,19,20,21,22,23].…”

mentioning

confidence: 99%

Assessing the Effects of Maternal HIV Infection on Child Birth Weight and Knowledge of HIV status on Breastfeeding using Observational Data in Malawi

Twabi

Manda

Small

2020

Preprint

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Background : Evidence has shown that maternal HIV infection has adverse effect on pregnancy outcomes including childbirth weight and that knowledge of mothers HIV status affects practice of exclusive breastfeeding for the first six month. Using methods for matching possible confounders, the purpose of this study were twofold: a) to assess whether or not the association of maternal HIV on childbirth weight was moderated by use of ART drugs and b) to determine if indeed knowledge of HIV status among mothers was associated with exclusive breastfeeding. Methods: Data on over 18,000 and 16,000 children still alive and born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys (MDHS) were analysed. A set of methods for confounder balance namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting the propensity score (PS) were used. Results: Using the 2010 data, maternal HIV infection had a negative effect on infant birth weight -149.0 (-324.2, -26.2) and -154.3 (-295.4, -13.3), under PS matching and PS inverse weighting respectively. Infant birth weights from HIV-infected mothers on ART and uninfected mothers were the same (mean: 3121.3, 95% CI: 3021.9, 3220.7) and (3273.7, 95% CI: 3259.1, 3288.3), respectively) and differed significantly from those HIV-infected mothers (3193.9, 95% CI: 3122.2, 3265.6). For the 2015-16 data, mothers who were HIV-infected gave birth to infants who significantly weighted more than infants from HIV-uninfected mothers 144.7 (40.4, 249.1) and 115.4 (11.6, 219.2), under PS matching and PS inverse weighting respectively. Knowledge of HIV status among mothers was not associated with their behaviour concerning exclusive breastfeeding for the 2010 and 2015-16 data. Conclusion: The association between maternal HIV infection and birth weight depended on the data used, with the 2010 data showing adverse effect. The higher birth weight among infants born to HIV infected mothers in 2015-16 maybe indicative of successes of policies and interventions within the PMTCT program in Malawi. The observed mitigating effect of ART usage by HIV infected mothers on child birth weight further confirms that PMTCT interventions should continue to be supported among antenatal clinics in Malawi.

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Impact of maternal HIV infection on perinatal outcomes: A systematic review

Atowoju,

Dawer,

Asrani

et al. 2024

Intl J Gynecology & Obste

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BackgroundMaternal HIV infection remains a significant global health concern with potential repercussions on perinatal outcomes. Emphasis on early intervention to improve peri‐ and postnatal outcomes in infected mothers and infants is a valid therapeutic concern.ObjectivesTo comprehensively analyze perinatal outcomes associated with maternal HIV infection and evaluate adverse effects associated with the HIV infection in the existing literature.Search StrategyA comprehensive search of PubMed, MEDLINE, and Google Scholar was conducted from 2013 to September 2023, using relevant MeSH terms.Selection CriteriaThe included studies encompassed original studies, cross‐sectional, prospective, retrospective studies and observational studies focused on perinatal outcomes in the context of maternal HIV infection.Data Collection and AnalysisThe selected studies underwent rigorous data collection and comprehensive quality checks and adhered to the PRISMA guidelines.Main ResultsNine eligible studies from Brazil, China, India, Malawi, Nigeria, Tanzania, the USA, and Canada were included. These studies have consistently demonstrated that maternal HIV infection is associated with adverse perinatal outcomes. The analysis revealed a higher risk of preterm birth (OR 1.57, 95% CI: 1.39–1.78), low birth weight (OR 1.33, 95% CI: 1.18–1.49), and small for gestational age (OR 1.38, 95% CI: 1.24–1.53) among infants born to mothers living with HIV. Notably, the impact of antiretroviral treatment (ART) on these outcomes varied, but maternal HIV infection remained a significant risk factor regardless of income level and geographic region.ConclusionMaternal HIV infection is consistently associated with adverse perinatal outcomes, emphasizing the need for targeted interventions and improved prenatal care in pregnant women with HIV infection.

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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

Cited by 6 publications

References 18 publications

Assessing the Effects of Maternal HIV Infection on Pregnancy Outcomes using Cross-sectional Data in Malawi

Assessing the Effects of Maternal HIV Infection on Pregnancy Outcomes using Cross-sectional Data in Malawi

Assessing the Effects of Maternal HIV Infection on Child Birth Weight and Knowledge of HIV status on Breastfeeding using Observational Data in Malawi

Impact of maternal HIV infection on perinatal outcomes: A systematic review

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