title: Association between maternal HIV infection and low birth weight and prematurity: a meta-analysis of cohort studies.
abstract: BACKGROUND
  To assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women.
  
  
  METHODS
  Several English and Chinese databases were searched (updated to May 2015) to find the studies reporting infant outcomes associated with exposure to maternal HIV infection during pregnancy. Relevant articles were manually selected based on several inclusion and exclusion criteria.
  
  
  RESULTS
  Fifty-two cohort studies including 15,538 (for LBW) and 200,896 (for PTD) HIV infected women met the inclusion criteria. There was significant heterogeneity among studies for maternal HIV infection associated with LBW/PTD (I(2) = 71.7%, P < 0.05, and I(2) = 51.8%, P < 0.05 for LBW and PTD, respectively). The meta-analysis demonstrated that the maternal HIV infection was significantly associated with both LBW (pooled odds ratio (OR): 1.73, 95% confidence interval (CI): 1.64, 1.82, P < 0.001) and PTD (pooled OR: 1.56, 95% CI: 1.49, 1.63, P < 0.001). No significant difference in the relationship between maternal HIV infection and adverse pregnancy outcomes was detected among the groups of different study periods. HIV infected women were at slightly higher risk of LBW in developing countries compared with women in developed countries (OR: 2.12 (95% CI: 1.81, 2.48) vs. 1.75 (95% CI: 1.44, 2.12)). Antiretroviral drugs usage did not significantly change the associations of maternal HIV exposure with LBW and PTD.
  
  
  CONCLUSIONS
  HIV infected women were at higher risk of having a low birth weight infant or a preterm delivery infant compared with uninfected women. Such associations did not change significantly over time or were not significantly affected by the usage of antiretroviral drugs.
authors.affiliation: Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xiaopl90@163.com.|Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xiaopl90@163.com.|Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xiaopl90@163.com.
authors.forename: Peng-Lei
authors.initials: PL
authors.lastname: Xiao
authors.affiliation: Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. ybzhou@fudan.edu.cn.|Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. ybzhou@fudan.edu.cn.|Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. ybzhou@fudan.edu.cn.
authors.forename: Yi-Biao
authors.initials: YB
authors.lastname: Zhou
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8 M5, Canada. yue.chen@uottawa.ca.
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Xuhui Center for Disease Prevention and Control, 50 Yongchuan Road, Xuhui District, Shanghai, 200032, China. 1057339623@qq.com.
authors.forename: Mei-Xia
authors.initials: MX
authors.lastname: Yang
authors.affiliation: Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xxsong@fudan.edu.cn.|Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xxsong@fudan.edu.cn.|Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. xxsong@fudan.edu.cn.
authors.forename: Xiu-Xia
authors.initials: XX
authors.lastname: Song
authors.affiliation: Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. 13211020008@fudan.edu.cn.|Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. 13211020008@fudan.edu.cn.|Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. 13211020008@fudan.edu.cn.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. jiangqw@fudan.edu.cn.|Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. jiangqw@fudan.edu.cn.|Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. jiangqw@fudan.edu.cn.
authors.forename: Qing-Wu
authors.initials: QW
authors.lastname: Jiang
mesh_terms: D001724:Birth Weight; D002681:China / Q000453:epidemiology; D019049:Developed Countries / Q000706:statistics & numerical data*; D003906:Developing Countries / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*