BACKGROUND: Few studies have assessed the determinants of birthweight in newborns from HIV-positive mothers in analyses that adjusted for different gestational age at delivery. METHOD: We calculated gestational age-adjusted birthweight Z-score values in a national series of 600 newborns from women with HIV and in 600 newborns form HIV-negative women matched for gender and gestational age. The determinants of Z-score values in newborns from HIV-positive mothers were assessed in univariate and multivariate regression analyses. RESULTS: Compared to newborns from HIV-negative women, newborns form HIV-positive women had significantly lower absolute birthweight (2799 vs 2887 g; p = .007) and birthweight Z score (-0.430 vs. -0.222; p < .001). AMong newborns from mother with HIV, the maternal characteristics associated with significantly lower Z-score values in univariate analyses were recent substance use (Z-score difference (ZSD) 0.612, 95% CI 0.359-0.864, p < .001), smoking <10 cigarettes/days (ZSD 0.323, 95% CI 0.129-0.518, p = .001), absence of pregnancies in the past (ZSD 0.200, 95% CI 0.050-0349, p = .009), non antiretroviral treatment in the past (ZSD 0.186, 95% CI 0.044-0.327, p = .010) and Caucasian ethnicity compared to Hispanic (ZSD =.248, 95% CI 0.022-0.475, p = .032). Body mass index (BMI) at conception and maternal glycemia levels during pregnancy were also significantly related to berthweight Z scores. Glycemia, BMI, and recent substance use maintained a significant association with Z score values in multivariate analyses. In the multivariate analysis, the only factors significantly associated with Z-score values below the 10th percentile were recent substance use (Adjusted odds ratio (AOR) 3.17, 95% CI 1.15-8.74) and smoking AOR 2.26, 95% CI 1.13-4.49). DISCUSSION: We identified serveral factors associated with gestationa age-adjusted birthweight in newborns from women with HIV. Smoking and substance use have a significant negative impact on intrauterine growth, which adds to an independent HIV-related effect on berthweight. Prevention and information on this issue should be reinforced in women with HIV of childbearing age to reduce the risk of negative outcomes in their offspring.

Factors influencing gestational age-adjusted birthweight in a national series of 600 newborns form mothers with HIV.

MACCABRUNI, ANNA;
2008-01-01

Abstract

BACKGROUND: Few studies have assessed the determinants of birthweight in newborns from HIV-positive mothers in analyses that adjusted for different gestational age at delivery. METHOD: We calculated gestational age-adjusted birthweight Z-score values in a national series of 600 newborns from women with HIV and in 600 newborns form HIV-negative women matched for gender and gestational age. The determinants of Z-score values in newborns from HIV-positive mothers were assessed in univariate and multivariate regression analyses. RESULTS: Compared to newborns from HIV-negative women, newborns form HIV-positive women had significantly lower absolute birthweight (2799 vs 2887 g; p = .007) and birthweight Z score (-0.430 vs. -0.222; p < .001). AMong newborns from mother with HIV, the maternal characteristics associated with significantly lower Z-score values in univariate analyses were recent substance use (Z-score difference (ZSD) 0.612, 95% CI 0.359-0.864, p < .001), smoking <10 cigarettes/days (ZSD 0.323, 95% CI 0.129-0.518, p = .001), absence of pregnancies in the past (ZSD 0.200, 95% CI 0.050-0349, p = .009), non antiretroviral treatment in the past (ZSD 0.186, 95% CI 0.044-0.327, p = .010) and Caucasian ethnicity compared to Hispanic (ZSD =.248, 95% CI 0.022-0.475, p = .032). Body mass index (BMI) at conception and maternal glycemia levels during pregnancy were also significantly related to berthweight Z scores. Glycemia, BMI, and recent substance use maintained a significant association with Z score values in multivariate analyses. In the multivariate analysis, the only factors significantly associated with Z-score values below the 10th percentile were recent substance use (Adjusted odds ratio (AOR) 3.17, 95% CI 1.15-8.74) and smoking AOR 2.26, 95% CI 1.13-4.49). DISCUSSION: We identified serveral factors associated with gestationa age-adjusted birthweight in newborns from women with HIV. Smoking and substance use have a significant negative impact on intrauterine growth, which adds to an independent HIV-related effect on berthweight. Prevention and information on this issue should be reinforced in women with HIV of childbearing age to reduce the risk of negative outcomes in their offspring.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/762234
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