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Clin Infect Dis. 2017 Sep 15;65(6):982-989. doi: 10.1093/cid/cix488.

Birth Weight and Preterm Delivery Outcomes of Perinatally vs Nonperinatally Human Immunodeficiency Virus-Infected Pregnant Women in the United States: Results From the PHACS SMARTT Study and IMPAACT P1025 Protocol.

Collaborators (178)

Yogev R, Sanders MA, Malee K, Hunter S, Shearer W, Paul M, Cooper N, Harris L, Purswani M, Stuard E, Cintron A, Puga A, Cooley D, Garvie PA, Blood J, Borkowsky W, Deygoo S, Vasserman M, Dieudonne A, Bettica L, Knapp K, Allison K, Wilkins M, Acevedo-Flores M, Angeli-Nieves L, Olivera V, Kohlhoff S, Dennie A, Bewley S, Dyke RV, Craig K, Sirois P, Crain M, Hickman P, Marullo D, Spector SA, Norris K, Nichols S, McFarland E, Chambers C, Wallace J, Barr E, Rathore M, Stowers K, Mahmoudi S, Usitalo A, Hayani K, Rich K, Richardson L, Smith R, Mitchell C, Dominguez S, Florez C, Frederick T, Davtyan M, Morales-Avendano G, Rodriguez ZM, Heyer I, Trifilio NS, Scott GB, Tuomala R, Smith E, Watts H, Oden KM, Huo Y, Patel K, Barr EA, Bardeguez A, Burchett SK, Livingston E, Stek AM, Basar MT, Hernandez A, Jennings A, Cressey TR, Bryant J, Tuomala R, Smith E, Oden KM, Kacanek D, Leister E, Shapiro DE, Barr EA, Wara DW, Bardeguez A, Burchett SK, Guiterrez J, Malee K, Robert H, Stek AM, Tanjutco P, Bryson Y, Basar MT, Adriane H, Jennings A, Cressey TR, Bryant J, Bardeguez AD, Bettica L, Calilap-Bernardo C, Higgins A, Silva G, Gaddipati S, Spector SA, Hull A, Caffery M, Manning J, Livingston E, Donnelly M, Wilson J, Giner J, Karthas N, Tucker L, Buck A, Kneut C, Deygoo S, Kaul A, Minter M, Akleh S, Robson A, Hitti J, Venema-Weiss C, Klastorin A, Bruder KL, Lewis G, Casey D, Parker S, Scott R, Tanjutco P, Emmanuel V, Mimoso A, Diaz R, Perez E, Pereira O, Griffin J, Ogburn P, Stek A, Kramer F, Spencer L, Kovacs A, Rathore M, Delke I, Thomas G, Millwood B, Katai A, Kennedy T, Kinzie K, Wallace J, Schmidt J, Cejtin H, McNichols M, Senka J, Cohan D, Anderson J, Sheridan-Malone E, Tolentino-Balbridge C, Jackson-Alvarez J, Michalik D, Batra JS, Watson D, Johnson M, Hilyard C, Maupin R, Dola C, Luster Y, Bradford S, Tita A, Parks M, Robbins S, Thorpe E, Knapp K, Finnie P, Sublette N, Zorrilla CD, Tamayo-Agrait V, Wright R, Cormier S, Luzuriaga K.

Author information

1
Departments of Medicine and Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
2
Department of Biostatistics, Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
3
Saban Research Institute of Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California.
4
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
5
Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
6
Department of Epidemiology, Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
7
Department of Obstetrics, Gynecology, and Women's Health, Rutgers New Jersey Medical School, Newark.
8
Division of Infectious Diseases, Boston Children's Hospital and Harvard Medical School, Massachusetts.
9
Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
10
Department of Pediatrics, Division of Pediatric Infectious Disease and Immunology, University of Miami Miller School of Medicine, Florida.
11
Department of Pediatrics, Section of Infectious Diseases, Tulane University School of Medicine, New Orleans, Louisiana.
12
Mailman School of Public Health and College of Physicians & Surgeons, International Center for AIDS Care and Treatment Program, Columbia University, New York, New York.

Abstract

Background:

Pregnancy outcomes of perinatally human immunodeficiency virus-infected women (PHIV) are poorly defined.

Methods:

We compared preterm delivery and birth weight (BW) outcomes (low BW [LBW], <2500 g), small-for-gestational-age [SGA], and BW z scores [BWZ]) in HIV-exposed uninfected infants of PHIV vs nonperinatally HIV-infected (NPHIV) pregnant women in the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities or International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 studies. Mixed effects models and log binomial models were used to assess the association of maternal PHIV status with infant outcomes. Age-stratified analyses were performed.

Results:

From 1998 to 2013, 2270 HIV-infected pregnant women delivered 2692 newborns (270 born to PHIV and 2422 to NPHIV women). PHIV women were younger, (mean age 21 vs 25 years, P < .01) and more likely to have a pregnancy CD4 count <200 cells/mm3 (19% vs 11%, P = .01). No associations between maternal PHIV status and preterm delivery, SGA, or LBW were observed. After adjustment, BWZ was 0.12 lower in infants of PHIV vs NPHIV women (adjusted mean, -0.45 vs -0.33; P = .04). Among women aged 23-30 years (n = 1770), maternal PHIV was associated with LBW (aRR = 1.74; 95% confidence interval, 1.18, 2.58; P < .01).

Conclusion:

The overall lack of association between maternal PHIV status and preterm delivery or infant BW outcomes is reassuring. The higher rates of LBW observed in PHIV women aged 23-30 years warrants further mechanism-based investigations as this is a rapidly growing and aging population worldwide.

Clinical Trials Registration:

PHACS SMARTT study, NCT01310023.

Clinical Trials Registration:

IMPAACT 1025, NCT00028145.

KEYWORDS:

birth weight; perinatal HIV infection; pregnancy; preterm delivery

PMID:
28575201
PMCID:
PMC5849107
DOI:
10.1093/cid/cix488
[Indexed for MEDLINE]
Free PMC Article

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