The association between maternal HIV infection and low birth weight at Chris Hani Baragwanath Academic Hospital

Phelp, Juliette Jane
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Background: Maternal HIV infection has been associated with infant low birth weight (LBW), whilst highly active antiretroviral therapy (HAART) has improved maternal health and reduced rates of mother to child transmission (MTCT) of HIV. Whether there is an association between maternal HIV and LBW in the context of HAART is uncertain. Methods: We used data from the V98_28OBTP study conducted at Chris Hani Baragwanath Academic Hospital from July 2014 to December 2016 to assess the association between maternal HIV infection, LBW and other variables. Results: Of 36 808 study participants 10 990 (29.9%) infants were HIV exposed and 25 818 (70.1%) were HIV unexposed with a mean birth weight (BW) of 2 948g (standard deviation (SD) ± 604g) and 3 061g (SD ± 599g) respectively (P<0.001). HIV infected infants tended to be smaller than HIV exposed uninfected infants, mean BW 2 680g (SD ± 679g) and 2 917g (SD ± 622g) respectively (P=0.063). The adjusted odds ratio (OR) for LBW as related to maternal HIV infection was 1.49 (95% confidence interval (CI) 1.35-1.64). Any maternal antiretroviral treatment was associated with reduced odds of LBW (OR 0.80, 95% CI 0.647-0.995). Other variables strongly associated with LBW included, maternal hypertension, poor maternal nutrition and prior pregnancy loss. Conclusion: Maternal HAART usage has improved LBW but a weak association between HIV exposure and LBW still exists
Original published work submitted to the Faculty of Health Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine