title: Association between low birth weight and infant mortality in children born to human immunodeficiency virus 1-infected mothers in Tanzania.
abstract: BACKGROUND
  The relationship between low birth weight and infant mortality among children born to human immunodeficiency virus (HIV)-infected mothers has not been thoroughly investigated.
  
  
  METHODS
  A total of 1078 HIV-infected pregnant women in Tanzania were followed up until delivery and with their infants thereafter. The babies' HIV status was assessed at birth, 6 weeks and every 3 months thereafter. Using Cox proportional hazards models, we estimated the associations of low birth weight with neonatal, post-neonatal and infant mortality and further examined whether the association between low birth weight and mortality was modified by pediatric HIV infection.
  
  
  RESULTS
  Among 823 singletons, low birth weight was strongly related to neonatal mortality (relative risk, 5.14; 95% confidence interval, 2.32-11.39). The association with postneonatal mortality was modified by child's HIV status. Among infants who were either negative or indeterminate at 6 weeks of age, low birth weight was associated with a 3-fold increased risk of mortality (relative risk, 3.16; 95% confidence interval, 1.36-7.37). In the positive infants, however, the association was no longer significant.
  
  
  CONCLUSIONS
  Although the importance of preventing HIV transmission cannot be overemphasized, efforts to reduce the incidence of low birth weight would enhance the benefit of preventing HIV transmission. Even in populations with no access to antiretroviral treatments, interventions to reduce the incidence of low birth weight would result in a significant reduction in infant mortality.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Ruilan
authors.initials: R
authors.lastname: Wei
authors.forename: Gernard I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Ellen
authors.initials: E
authors.lastname: Hertzmark
authors.forename: Ana
authors.initials: A
authors.lastname: Baylin
authors.forename: Karim
authors.initials: K
authors.lastname: Manji
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D016001:Confidence Intervals; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D013636:Tanzania / Q000453:epidemiology