title: Birth outcome in HIV vertically-exposed children in two Romanian centers.
abstract: BACKGROUND
  The Romanian HIV epidemic is characterized by a high prevalence among children born in the late '80s, perinatally infected. The impact of long-term treatment on their offspring is unknown. We evaluated the influence of prenatal care on the rate of premature birth among the HIV-exposed children of heavily treated HIV-infected mothers in two Romanian centers.
  
  
  METHODS
  We retrospectively analyzed data on all patients born by HIV-infected mothers between 2006 and 2012 followed up in two main regional centers. We compared the rate of premature birth and the differences between the sites regarding children and maternal demographic characteristics and antiretroviral exposure in pregnant women.
  
  
  RESULTS
  A total of 358 children born to 315 women were enrolled between 2006-2012, 262 children from the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" Bucharest (NIID) and 96 children from the Clinical Infectious Diseases Hospital Constanţa (IDHC). Gender rate in newborns and mean age in mothers were similar. We recorded statistically significant differences between centers in the rate of HIV vertical transmission (16.8% vs. 6.2%, p=0.002) and prematurity (25.2 vs. 14.6%, p=0.023). The most used antiretroviral combination during pregnancy in IDHC was boosted lopinavir and fixed dose zidovudine-lamivudine (66% of cases), while in NIID a greater diversity of antiretrovirals were used. Women from IDHC were more frequently treated during pregnancy (83.3% vs. 68.6%, p=0.004). HCV coinfection and illegal drug use were associated with prematurity in the NIID cohort (p=0.037, p=0.024).
  
  
  CONCLUSIONS
  We found a higher rate of premature birth and HIV infection in NIID. In IDHC we found a higher rate of low birth weight in children and a higher rate of heavily treated women. Prematurity was associated with hepatitis C infection and illegal drug use in the NIID cohort.
authors.affiliation: MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Tudor
authors.affiliation: MD, PhD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
authors.forename: Mariana
authors.initials: M
authors.lastname: Mărdărescu
authors.affiliation: MD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Petre
authors.affiliation: MD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Neagu Drăghicenoiu
authors.affiliation: MD, Pediatric Department, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
authors.forename: Rodica
authors.initials: R
authors.lastname: Ungurianu
authors.affiliation: MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş" Carol Davila, University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Cătălin
authors.initials: C
authors.lastname: Tilişcan
authors.affiliation: MD, PhD, National Institute for Infectious Diseases "Prof Dr Matei Balş", Bucharest, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Oţelea
authors.affiliation: MD, PhD Pediatric Department, Infectious Diseases Hospital Constanţa, Faculty of Medicine, Ovidius University of Constanţa, Romania.
authors.forename: Simona Claudia
authors.initials: SC
authors.lastname: Cambrea
authors.affiliation: MD, Pediatric Department Infectious Diseases Hospital Constanţa, Romania.
authors.forename: Doina Eugenia
authors.initials: DE
authors.lastname: Tănase
authors.affiliation: Psychologist, Executive Director Baylor Black Sea Foundation, Constanţa, Romania.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Schweitzer
authors.affiliation: MD, PhD, Ştefan S. Nicolau Institute of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Ruţă
keywords: HIV exposure; antiretroviral drugs; prematurity