Low Birth Weight in Perinatally HIV-Exposed Uninfected Infants: Observations in Urban Settings in Cameroon

Abstract

BackgroundThe consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG.MethodsThe data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007–2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (−2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG.ResultsAmong the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6–6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0–8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4–0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3–2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0–2.0) were identified as other contributors to SGAG.ConclusionMaternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are symptomatic, to minimize additional risk factors for SGAG.

Child Growth According to Maternal and Child HIV Status in Zimbabwe

“…A key finding from this study is that HEU infants had poorer growth than HIV-unexposed infants during infancy. Consistent with most 25 , 29 , 31 – 33 but not all 34 , 35 previous studies, HEU infants in this cohort had lower mean birth weights and a higher prevalence of LBW than HIV-unexposed infants, indicating an excess risk of IU growth failure; LBW and small-for-gestational-age in HEU infants are associated with increased mortality in the first year of life. 36 – 40 By 6 weeks of age, LAZ and WLZ were significantly lower in HEU compared with HIV-unexposed infants and remained significantly lower throughout the first year of life.…”

An assessment of option B implementation for the prevention of mother to child transmission in Dschang, Cameroon: results from the DREAM (Drug Resource Enhancement against AIDS and Malnutrition) cohort

“…The proportion of children born with a low birthweight was 17% in our study, which is higher than data for the general population in Cameroon [ 25 ] but comparable to data from other studies of infants born to HIV+ mothers in the country [ 11 , 26 ]. Some past studies have expressed concern regarding the potential impact of ART treatment on low birth weight [ 27 ], especially if PI containing regimens are used [ 28 ].…”

Different factors associated with loss to follow-up of infants born to HIV-infected or uninfected mothers: observations from the ANRS 12140-PEDIACAM study in Cameroon

“…However, visits (follow-up visits) are designated hereafter as the first, second and third, independent of the age of the child. Samples for HIV virological testing were collected from HIV-exposed infants at the first follow-up visit (scheduled for 6 weeks), as previously described [ 13 , 14 ]. HIV test results were provided at the second visit (scheduled for 10 weeks).…”