Risk factors for very preterm delivery and delivery of very‐small‐for‐gestational‐age infants among HIV‐exposed and HIV‐unexposed infants in Botswana

International Journal of Gynecology & Obstetrics - Tập 115 - Trang 20-25 - 2011
Natasha Parekh1, Heather Ribaudo2, Sajini Souda3, Jennifer Chen4, Mompati Mmalane3, Kathleen Powis3,5,6, Max Essex3,5, Joseph Makhema3, Roger L. Shapiro7,5,8
1University of Miami Miller School of Medicine, Miami, USA
2Harvard School of Public Health, Department of Biostatistics, Boston, USA
3Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
4Brigham and Women's Hospital, Boston, USA
5Harvard School of Public Health, Department of Immunology and Infectious Diseases, Boston, USA
6Massachusetts General Hospital, Boston, USA
7Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
8Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, USA

Tóm tắt

AbstractObjectiveTo evaluate risk factors for very preterm delivery (VPTD) and very‐small‐for‐gestational‐age (VSGA) births in a country with a high HIV prevalence.MethodsObstetric 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.ResultsOf 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).ConclusionHypertension 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.

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International Journal of Gynecology & Obstetrics

Tập 115

20-25

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