Perinatal human immunodeficiency virus-1 transmission and intrauterine growth: a cohort study in Butare, Rwanda.
OBJECTIVE
To study the association of perinatal human immunodeficiency virus (HIV)-1 transmission with birth outcomes, including birth weight, gestational age, ponderal index, head circumference, and weight/head ratio.


METHODS
Data from a prospective cohort study of 627 pregnant women and their infants in Butare, Rwanda, from October 1989 until April 1994 were analyzed. A total of 318 HIV-1-infected and 309 seronegative women were enrolled during pregnancy and gave birth to 590 live singletons. Multiple linear regression modeling was used to assess the association of mother-child HIV status with several birth outcome measures.


RESULTS
Unadjusted mean birth weight of HIV- infected infants was 235 g (95% confidence interval [CI] = 94 to 376 g) less than that of HIV-uninfected infants born to HIV-positive mothers (the reference group). After adjustment for gestational age, socioeconomic factors, maternal age, parity, hematocrit, and anthropomorphic measures, mean birth weight of HIV-infected infants was 154 g (95% CI = 38 to 271 g) lower than that of the reference group. When infants born to HIV-seronegative mothers were compared with the reference group, mean birth weights did not differ. Adjusted models resulted in estimates of mean head circumference 0.6 cm smaller (95% CI = 0.2 to 1.1 cm), ponderal index 0.14 lower (95% CI = 0.05 to 0.23), weight/head ratio 3.5 lower (95% CI = 0.5 to 6.4), and gestational age 0.5 weeks shorter (95% CI = 0.1 to 0.9 weeks) for HIV-infected infants than for the reference group.


CONCLUSIONS
After adjustment for potential confounding variables, this study showed statistically significant differences in birth weight, gestational age, ponderal index, and weight/head ratio when HIV-infected infants were compared with noninfected infants born to HIV-positive mothers. HIV-1, mother-to-child transmission, Africa, intrauterine growth, birth weight, gestational age, ponderal index.
Weng
S
S
Division of Community Medicine, Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Bulterys
M
M
Chao
A
A
Stidley
C A
CA
Dushimimana
A
A
Mbarutso
E
E
Saah
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001724:Birth Weight; D016516:CD4-CD8 Ratio; D016022:Case-Control Studies; D002508:Cephalometry; D015331:Cohort Studies; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D004522:Educational Status; D005314:Embryonic and Fetal Development; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008403:Mass Screening; D008423:Maternal Age; D008429:Maternal Welfare; D015999:Multivariate Analysis; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011897:Random Allocation; D012307:Risk Factors; D012432:Rwanda / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology