Effect of maternal HIV status on infant mortality: evidence from a 9-month follow-up of mothers and their infants in Zimbabwe.
OBJECTIVE
To describe infant mortality trends and associated factors among infants born to mothers enrolled in a prevention of mother-to-child transmission (PMTCT) program.


METHODS
A nested case-control study of human immunodeficiency virus (HIV)-positive and -negative pregnant women enrolled from the national PMTCT program at 36 weeks of gestation attending three peri-urban clinics in Zimbabwe offering maternal and child health care. Mother-infant pairs were followed up from delivery, and at 6 weeks, 4 months and 9 months.


RESULTS
A total of 1045 mother and singleton infant pairs, 474 HIV-positive and 571 HIV-negative mothers, delivered 469 and 569 live infants, respectively. Differences in mortality were at 6 weeks and 4 months, RR (95% CI) 9.71 (1.22 to 77.32) and 21.84 (2.93 to 162.98), respectively. Overall, 9-month mortality rates were 150 and 47 per 1000 person-years for infants born to HIV-positive and HIV-negative mothers, respectively. Proportional hazard ratio of mortality for children born to HIV-positive mothers was 3.21 (1.91 to 5.38) when compared with that for children born to HIV-negative mothers.


CONCLUSIONS
Maternal HIV exposure was associated with higher mortality in the first 4 months of life. Infant's HIV status was the strongest predictor of infant mortality. There is a need to screen infants for HIV from delivery and throughout breastfeeding.
Kurewa
E N
EN
Department of Obstetrics and Gynaecology, University of Zimbabwe, Avondale, Harare, Zimbabwe. enkurewa@hotmail.com
Gumbo
F Z
FZ
Munjoma
M W
MW
Mapingure
M P
MP
Chirenje
M Z
MZ
Rusakaniko
S
S
Stray-Pedersen
B
B
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000401:mortality* / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D019829:Nevirapine / Q000008:administration & dosage; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D016016:Proportional Hazards Models; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
D019380:Anti-HIV Agents; D019829:Nevirapine
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