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PLOS ONE  2014 

Low Birth Weight in Perinatally HIV-Exposed Uninfected Infants: Observations in Urban Settings in Cameroon

DOI: 10.1371/journal.pone.0093554

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Abstract:

Background 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. Methods 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. Results 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. Conclusion 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.

References

[1]  Bailey RC, Kamenga MC, Nsuami MJ, Nieburg P, St Louis ME (1999) Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo. Int J Epidemiol 28: 532–40. doi: 10.1093/ije/28.3.532
[2]  Dreyfuss ML, Msamanga GI, Spiegelman D, Hunter DJ, Urassa EJ, et al. (2001) Determinants of low birth weight among HIV-infected pregnant women in Tanzania. Am J Clin Nutr 74: 814–26.
[3]  Lepage P, Msellati P, Hitimana DG, Bazubagira A, Van Goethem C, et al. (1996) Growth of human immunodeficiency type 1-infected and uninfected children: a prospective cohort study in Kigali, Rwanda, 1988 to 1993. Pediatr Infect Dis J 15: 479–85. doi: 10.1097/00006454-199606000-00003
[4]  Makasa M, Kasonka L, Chisenga M, Sinkala M, Chintu C, et al. (2007) Early growth of infants of HIV-infected and uninfected Zambian women. Trop Med Int Health 12: 594–602. doi: 10.1111/j.1365-3156.2007.01836.x
[5]  Marinda E, Humphrey JH, Iliff PJ, Mutasa K, Nathoo KJ, et al. (2007) Child mortality according to maternal and infant HIV status in Zimbabwe. Pediatr Infect Dis J 26: 519–26. doi: 10.1097/01.inf.0000264527.69954.4c
[6]  McNally LM, Jeena PM, Gajee K, Thula SA, Sturm AW, et al. (2007) Effect of age, polymicrobial disease, and maternal HIV status on treatment response and cause of severe pneumonia in South African children: a prospective descriptive study. Lancet 369: 1440–51. doi: 10.1016/s0140-6736(07)60670-9
[7]  Ndirangu J, Newell ML, Bland RM, Thorne C (2012) Maternal HIV infection associated with small-for-gestational age infants but not preterm births: evidence from rural South Africa. Human reproduction 27: 1846–56. doi: 10.1093/humrep/des090
[8]  Rollins NC, Coovadia HM, Bland RM, Coutsoudis A, Bennish ML, et al. (2007) Pregnancy outcomes in HIV-infected and uninfected women in rural and urban South Africa. J Acquir Immune Defic Syndr 44: 321–8. doi: 10.1097/qai.0b013e31802ea4b0
[9]  Wei R, Msamanga GI, Spiegelman D, Hertzmark E, Baylin A, et al. (2004) Association between low birth weight and infant mortality in children born to human immunodeficiency virus 1-infected mothers in Tanzania. Pediatr Infect Dis J 23: 530–5. doi: 10.1097/01.inf.0000129691.42964.eb
[10]  McGrath CJ, Nduati R, Richardson BA, Kristal AR, Mbori-Ngacha D, et al. (2012) The prevalence of stunting is high in HIV-1-exposed uninfected infants in Kenya. J Nutr 142: 757–63. doi: 10.3945/jn.111.148874
[11]  Castetbon K, Ladner J, Leroy V, Chauliac M, Karita E, et al. (1999) Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy: Pregnancy and HIV Study Group (EGE). J Trop Pediatr 45: 152–7. doi: 10.1093/tropej/45.3.152
[12]  Ebrahim GJ (1996) Malaria during pregnancy. J Trop Pediatr 42: 62–3.
[13]  Mwanyumba F, Claeys P, Gaillard P, Verhofstede C, Chohan V, et al. (2001) Correlation between maternal and infant HIV infection and low birth weight: a study in Mombasa, Kenya. J Obstet Gynaecol 21: 27–31. doi: 10.1080/01443610020022078
[14]  Stratton P, Tuomala RE, Abboud R, Rodriguez E, Rich K, et al. (1999) Obstetric and newborn outcomes in a cohort of HIV-infected pregnant women: a report of the women and infants transmission study. J Acquir Immune Defic Syndr Hum Retrovirol 20: 179–86. doi: 10.1097/00042560-199902010-00011
[15]  Verhoeff FH, Brabin BJ, van Buuren S, Chimsuku L, Kazembe P, et al. (2001) An analysis of intra-uterine growth retardation in rural MalawiChanges in haemoglobin levels in infants in Malawi: effect of low birth weight and fetal anaemia. Eur J Clin Nutr 55: 682–9. doi: 10.1038/sj.ejcn.1601200
[16]  Watson-Jones D, Weiss HA, Changalucha JM, Todd J, Gumodoka B, et al. (2007) Adverse birth outcomes in United Republic of Tanzania–impact and prevention of maternal risk factors. Bull World Health Organ 85: 9–18. doi: 10.2471/blt.06.033258
[17]  Kalanda BF, van Buuren S, Verhoeff FH, Brabin BJ (2005) Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status. Arch Dis Child Fetal Neonatal Ed 90: F161–5. doi: 10.1136/adc.2004.054650
[18]  European Collaborative Study (2003) Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women. J Acquir Immune Defic Syndr 32: 380–7. doi: 10.1097/00126334-200304010-00006
[19]  Venkatesh KK, Lurie MN, Triche EW, De Bruyn G, Harwell JI, et al. (2010) Growth of infants born to HIV-infected women in South Africa according to maternal and infant characteristics. Trop Med Int Health 15: 1364–74. doi: 10.1111/j.1365-3156.2010.02634.x
[20]  Briand N, Le Coeur S, Traisathit P, Karnchanamayul V, Hansudewechakul R, et al. (2006) Growth of human immunodeficiency virus-uninfected children exposed to perinatal zidovudine for the prevention of mother-to-child human immunodeficiency virus transmission. Pediatr Infect Dis J 25: 325–32. doi: 10.1097/01.inf.0000207398.10466.0d
[21]  Briand N, Mandelbrot L, Le Chenadec J, Tubiana R, Teglas JP, et al. (2009) No relation between in-utero exposure to HAART and intrauterine growth retardation. Aids 23: 1235–43. doi: 10.1097/qad.0b013e32832be0df
[22]  Ekouevi DK, Coffie PA, Becquet R, Tonwe-Gold B, Horo A, et al. (2008) Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Cote d’Ivoire. Aids 22: 1815–20. doi: 10.1097/qad.0b013e32830b8ab9
[23]  Townsend CL, Cortina-Borja M, Peckham CS, Tookey PA (2007) Antiretroviral therapy and premature delivery in diagnosed HIV-infected women in the United Kingdom and Ireland. Aids 21: 1019–26. doi: 10.1097/qad.0b013e328133884b
[24]  Filteau S (2009) The HIV-exposed, uninfected African child. Trop Med Int Health 14: 276–87. doi: 10.1111/j.1365-3156.2009.02220.x
[25]  Isanaka S, Duggan C, Fawzi WW (2009) Patterns of postnatal growth in HIV-infected and HIV-exposed children. Nutr Rev 67: 343–59. doi: 10.1111/j.1753-4887.2009.00207.x
[26]  Tejiokem MC, Faye A, Penda IC, Guemkam G, Ateba Ndongo F, et al. (2011) Feasibility of early infant diagnosis of HIV in resource-limited settings: the ANRS 12140-PEDIACAM study in Cameroon. PLoS One 6: e21840. doi: 10.1371/journal.pone.0021840
[27]  WHO (2006). Médicaments antirétroviraux pour traiter la femme enceinte et prévenir l’infection à VIH chez l’enfant. Vers un accès universel. Recommandations pour une approche de santé publique 2006. Available: http://www.who.int/hiv/pub/mtct/arv_guid?elines_mtct_fr.pdf. Accessed 22 January 2014.
[28]  Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P (2003) International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24-October 1, 2001. Pediatrics 111: 1253–61. doi: 10.1542/peds.111.6.1253
[29]  Association des Utilisateurs de Dossiers Informatisés en Pédiatrie Obstétrique et Gynécologie. AUDIPOG. Available: http://www.audipog.net/courbes_morpho.ph?p, accessed date 16/01/2014.
[30]  Bouyer J, Hémon D, Cordier S, Derriennic F, Stücker I, et al.(1995) Epidémiologie Principes et méthodes quantitatives. INSERM ed. 499 p.
[31]  Kourtis AP, Bulterys M, Nesheim SR, Lee FK (2001) Understanding the timing of HIV transmission from mother to infant. Jama 285: 709–12. doi: 10.1001/jama.285.6.709
[32]  Ryder RW, Nsa W, Hassig SE, Behets F, Rayfield M, et al. (1989) Perinatal transmission of the human immunodeficiency virus type 1 to infants of seropositive women in Zaire. N Engl J Med 320: 1637–42. doi: 10.1056/nejm198906223202501
[33]  Moye J Jr, Rich KC, Kalish LA, Sheon AR, Diaz C, et al. (1996) Natural history of somatic growth in infants born to women infected by human immunodeficiency virus. Women and Infants Transmission Study Group. J Pediatr 128: 58–69. doi: 10.1016/s0022-3476(96)70428-6
[34]  Floridia M, Ravizza M, Bucceri A, Lazier L, Vigano A, et al. (2008) Factors influencing gestational age-adjusted birthweight in a national series of 600 newborns from mothers with HIV. HIV Clin Trials 9: 287–97. doi: 10.1310/hct0905-287
[35]  Clerici M, Saresella M, Colombo F, Fossati S, Sala N, et al. (2000) T-lymphocyte maturation abnormalities in uninfected newborns and children with vertical exposure to HIV. Blood 96: 3866–71.
[36]  Faye A, Pornprasert S, Mary JY, Dolcini G, Derrien M, et al. (2007) Characterization of the main placental cytokine profiles from HIV-1-infected pregnant women treated with anti-retroviral drugs in France. Clin Exp Immunol 149: 430–9. doi: 10.1111/j.1365-2249.2007.03411.x
[37]  Kfutwah A, Mary JY, Lemen B, Leke R, Rousset D, et al. (2009) Plasmodium falciparum infection significantly impairs placental cytokine profile in HIV infected Cameroonian women. PLoS One 4: e8114. doi: 10.1371/journal.pone.0008114
[38]  Sombié I, Nacro B, Tiendrébéogo S, Dao B, Cartoux M, et al. (1999) Infection maternelle par le VIH et paramètres anthropométriques de l’enfant à la naissance au Burkina Faso. Cahiers santé 9: 173–7.
[39]  BBS/UNICEF (2005). National Low Birth Weight Survey of Bangladesh, 2003–2004: Bangladesh Bureau of Statistics. Available: http://www.unicef.org/bangladesh/Low_Bir?th_Weight_report.pdf. Accessed 27 September 2013.
[40]  Bernstein PS, Divon MY (1997) Etiologies of Fetal Growth Restriction. Clinical Obstetrics and Gynecology 40: 723–729. doi: 10.1097/00003081-199712000-00006
[41]  Naniche D, Bardaji A, Lahuerta M, Berenguera A, Mandomando I, et al. (2009) Impact of maternal human immunodeficiency virus infection on birth outcomes and infant survival in rural Mozambique. Am J Trop Med Hyg 80: 870–6.

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