Low birth weight in perinatally HIV-exposed uninfected infants: observations in urban settings in Cameroon
Sofeu, C.L.; Warszawski, J.; Ateba Ndongo, F.; Penda, I.C.; Tetang Ndiang, S.; Guemkam, G.; Makwet, N.; Owona, F.él.é; Kfutwah, A.; Tchendjou, P.; Texier, G.ët.; Tchuente, M.; Faye, A.; Tejiokem, M.C.; Faye, A.; Tejiokem, M.C.; Barré-Sinoussi, F.ço.; Scott, D.; Tangy, F.éd.ér.; Warszawski, J.; Blanche, S.ép.; Dollfus, C.; Baril, L.; Kfutwah, A.; Penda, I.; Guemkam, G.; Francis, A.N.; Biya, C.; Ndiang, S.T.; Denise, E.; William, M.; Alain, N.P.; Félicité, O.; Ledoux, S.C.; Gaëtan, T.;
Plos one 9(4): E93554
2014
ISSN/ISBN: 1932-6203 PMID: 24705410 DOI: 10.1371/journal.pone.0093554Document Number: 626021
The consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG. The data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007-2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (-2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG. Among the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6-6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0-8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4-0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3-2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0-2.0) were identified as other contributors to SGAG. Maternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are symptomatic, to minimize additional risk factors for SGAG.