Factors influencing gestational age-adjusted birthweight in a national series of 600 newborns from mothers with HIV.
BACKGROUND
Few studies have assessed the determinants of birthweight in newborns from HIV-positive mothers in analyses that adjusted for different gestational age at delivery.


METHODS
We calculated gestational age-adjusted birthweight Z-score values in a national series of 600 newborns from women with HIV and in 600 newborns from HIV-negative women matched for gender and gestational age. The determinants of Z-score values in newborns from HIV-positive mothers were assessed in univariate and multivariate regression analyses.


RESULTS
Compared to newborns from HIV-negative women, newborns from HIV-positive women had significantly lower absolute birthweight (2799 vs. 2887 g; p = .007) and birthweight Z score (-0.430 vs. -0.222; p < .001). Among newborns from mothers with HIV, the maternal characteristics associated with significantly lower Z-score values in univariate analyses were recent substance use (Z-score difference [ZSD] 0.612, 95% CI 0.359-0.864, p < .001), smoking >10 cigarettes/day (ZSD 0.323, 95% CI 0.129-0.518, p = .001), absence of pregnancies in the past (ZSD 0.200, 95% CI 0.050-0.349, p = .009), no antiretroviral treatment in the past (ZSD 0.186, 95% CI 0.044-0.327, p = .010), and Caucasian ethnicity compared to Hispanic (ZSD 0.248, 95% CI 0.022-0.475, p = .032). Body mass index (BMI) at conception and maternal glycemia levels during pregnancy were also significantly related to birthweight Z scores. Glycemia, BMI, and recent substance use maintained a significant association with Z-score values in multivariate analyses. In the multivariate analysis, the only factors significantly associated with Z-score values below the 10th percentile were recent substance use (adjusted odds ratio [AOR] 3.17, 95% CI 1.15-8.74) and smoking (AOR 2.26, 95% CI 1.13-4.49).


CONCLUSIONS
We identified several factors associated with gestational age-adjusted birthweight in newborns from women with HIV. Smoking and substance use have a significant negative impact on intrauterine growth, which adds to an independent HIV-related effect on birthweight. Prevention and information on this issue should be reinforced in women with HIV of childbearing age to reduce the risk of negative outcomes in their offspring.
Floridia
Marco
M
Department of Drug Research and Evaluation, Istituto Superiore di Sanità (ISS), Rome, Italy. marco.floridia@iss.it
Ravizza
Marina
M
Bucceri
Anna
A
Lazier
Luisella
L
Viganò
Alessandra
A
Alberico
Salvatore
S
Guaraldi
Giovanni
G
Anzidei
Gianfranco
G
Guerra
Brunella
B
Citernesi
Angela
A
Sansone
Matilde
M
Baroncelli
Silvia
S
Tamburrini
Enrica
E
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D005865:Gestational Age; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult