The association between HIV/AIDS during pregnancy and fetal growth parameters in Florida: a population based study.
In this population-based retrospective study, we sought to investigate the association between HIV/AIDS during pregnancy and adverse birth outcomes, including low birth weight (LBW), very low birth weight (VLBW), preterm birth (PTB), very preterm birth (VPTB), and small for gestational age (SGA), among women in Florida by sociodemographic variables. Using data from Florida's maternally linked birth cohort files, we examined singleton live births in the state during 1998 to 2007 (N = 1,698,107). The study population was categorized based on the maternal HIV/AIDS status. Poisson regression models were used to generate adjusted rate ratios (ARR) to estimate the association between HIV/AIDS status and fetal growth parameters. The main outcome measures were fetal growth parameters, including LBW, VLBW, PTB, VPTB, and SGA. As compared to HIV/AIDS-negative women, mothers with HIV/AIDS had elevated risks for LBW (ARR = 1.40; 95% CI = 1.30-1.50), VLBW (ARR = 1.25; 95% CI = 1.04-1.51), SGA (ARR = 1.26; 95% CI = 1.17-1.35), PTB (ARR = 1.23; 95% CI = 1.03-1.47), and VPTB (ARR = 1.27; 95% CI = 1.20-1.36). Risk estimates for LBW and SGA were highest among Hispanics mothers with HIV/AIDS, while white mothers with HIV/AIDS had the highest risk levels for VLBW and PTB, compared to their HIV/AIDS negative counterparts. Our findings show that women with HIV/AIDS have elevated risks for inhibited fetal growth and shortened gestation with important racial/ethnic variation. This is the first known population-based study that reveals racial/ethnic differences in HIV/AIDS-related fetal growth morbidity outcomes.
University of South Florida, College of Public Health, Department of Epidemiology and Biostatistics, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA. hsalihu@health.usf.edu
Hamisu M
HM
Salihu
Kara M
KM
Stanley
Euna M
EM
August
Hanna
H
Weldeselasse
Alfred K
AK
Mbah
Valerie E
VE
Whiteman
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000208:ethnology; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000704:Analysis of Variance; D004522:Educational Status; D005260:Female; D005317:Fetal Growth Retardation; D005431:Florida / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight; D008423:Maternal Age; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data