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.
Division of Community Medicine, Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
S
S
Weng
M
M
Bulterys
A
A
Chao
C A
CA
Stidley
A
A
Dushimimana
E
E
Mbarutso
A
A
Saah
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