title: Adverse Neonatal Outcomes Among Women Living With HIV: A Population-Based Study.
abstract: BACKGROUND
  There have been few population-based studies describing the risk of adverse neonatal outcomes among women living with HIV in Canada. Accordingly, we compared the risk of preterm birth (PTB), low birth weight (LBW) and small for gestational age births among Ontario women aged 18 to 49 years living with and without HIV infection.
  
  
  METHODS
  We conducted a population-based study using Ontario health administrative data. Generalized estimating equations with a logit link function were used to derive adjusted odds ratios (aORs) and 95% confidence intervals for the association of HIV infection with adverse neonatal outcomes.
  
  
  RESULTS
  Between 2002-2003 and 2010-2011, a total of 1 113 874 singleton live births were available for analysis, of which 615 (0.06%) were to women living with HIV. The proportion of singleton births that were SGA (14.6% vs. 10.3%; P < 0.001), PTB (14.6% vs. 6.3%; P < 0.001), and LBW (12.5% vs. 4.6%; P < 0.001) were higher among women living with HIV than among women without HIV. Following multivariable adjustment, the risks of PTB (aOR 1.76; 95% CI 1.38 to 2.24), SGA (aOR 1.43; 95% CI 1.12 to 1.81), and LBW (aOR 1.90; 95% CI 1.47 to 2.45) were higher for women living with HIV than for women without HIV.
  
  
  CONCLUSIONS
  Women with HIV are at higher risk of adverse neonatal outcomes than HIV-negative women. Further research is required to develop preconception and prenatal interventions that could reduce the excess burden of poor pregnancy outcomes among women living with HIV.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Macdonald
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON.
authors.forename: Ryan
authors.initials: R
authors.lastname: Ng
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Department of Medicine, University of Toronto, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Bayoumi
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON; Toronto General Research institute, University Health Network, Toronto ON; Dalla Lana School of Public Health, University of Toronto, Toronto ON.
authors.forename: Janet
authors.initials: J
authors.lastname: Raboud
authors.affiliation: Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa ON.
authors.forename: Jason
authors.initials: J
authors.lastname: Brophy
authors.affiliation: Women's College Research institute, Women's College Hospital, Toronto ON.
authors.forename: Khatundi-Irene
authors.initials: KI
authors.lastname: Masinde
authors.affiliation: Women's Health in Women's Hands Community Health Centre, Toronto ON.
authors.forename: Wangari E
authors.initials: WE
authors.lastname: Tharao
authors.affiliation: Li Ka Shing Knowledge institute, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON; Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto ON.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yudin
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Department of Medicine, University of Toronto, Toronto ON; Women's College Research institute, Women's College Hospital, Toronto ON.
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON; Dalla Lana School of Public Health, University of Toronto, Toronto ON; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto ON.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glazier
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON.
authors.forename: Tony
authors.initials: T
authors.lastname: Antoniou
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth; D018570:Risk Assessment; D012307:Risk Factors
keywords: HIV; low birth weight; pregnancy; preterm birth; small for gestational age