Premium
Risk factors for very preterm delivery and delivery of very‐small‐for‐gestational‐age infants among HIV‐exposed and HIV‐unexposed infants in Botswana
Author(s) -
Parekh Natasha,
Ribaudo Heather,
Souda Sajini,
Chen Jennifer,
Mmalane Mompati,
Powis Kathleen,
Essex Max,
Makhema Joseph,
Shapiro Roger L.
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.04.008
Subject(s) - medicine , pregnancy , obstetrics , small for gestational age , odds ratio , birth weight , gestational age , gestational hypertension , low birth weight , human immunodeficiency virus (hiv) , pediatrics , antiretroviral therapy , gestation , viral load , immunology , genetics , biology
Objective To evaluate risk factors for very preterm delivery (VPTD) and very‐small‐for‐gestational‐age (VSGA) births in a country with a high HIV prevalence. Methods Obstetric records at 6 hospitals across Botswana were reviewed at delivery; VPTD was defined as birth before 32 weeks of pregnancy and VSGA as birth weight below the 3rd percentile for Botswana‐specific norms. Results Of 16 219 live births born after 26 weeks of pregnancy, 701 (4.3%) were delivered very preterm and 607 (3.7%) were VSGA; 4347 (28.4%) were documented as HIV‐exposed. In a multivariable analysis, HIV infection and hypertension during pregnancy were associated with a VPTD (adjusted odds ratio [AOR]: HIV 1.65, hypertension 1.75) and a VSGA birth (AOR: HIV infection 1.90, hypertension 3.44). Among HIV‐infected women, the continuation of highly active antiretroviral therapy (HAART) from before conception was associated with a VSGA birth (AOR 1.75) but not with a VPTD (AOR 0.78). In a secondary analysis, HAART continuation was associated with hypertension during pregnancy (AOR 1.34). Conclusion Hypertension and HIV infection were risk factors for a VPTD and a VSGA birth. Continuation of HAART from before conception was associated with a VSGA birth but not with a VPTD.