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. 2014 Apr 3;9(4):e93554.
doi: 10.1371/journal.pone.0093554. eCollection 2014.

Low birth weight in perinatally HIV-exposed uninfected infants: observations in urban settings in Cameroon

Casimir Ledoux Sofeu  1 , Josiane Warszawski  2 , Francis Ateba Ndongo  3 , Ida Calixte Penda  4 , Suzie Tetang Ndiang  5 , Georgette Guemkam  6 , Nicaise Makwet  7 , Félicité Owona  8 , Anfumbom Kfutwah  9 , Patrice Tchendjou  8 , Gaëtan Texier  10 , Maurice Tchuente  11 , Albert Faye  12 , Mathurin Cyrille Tejiokem  13 ; ANRS-PEDIACAM Study Group
Collaborators, Affiliations

Low birth weight in perinatally HIV-exposed uninfected infants: observations in urban settings in Cameroon

Casimir Ledoux Sofeu et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study population and frequency of SGAG, ANRS 12140-Pediacam study, Cameroon, 2007–2010.
*Birth outcomes refer to birth weight and gestational age. † 9.3% (346) of infants were excluded from the multivariate analysis because of data for potentially associated factors were missing. ‡SGAG: small for gestational age and gender.
See this image and copyright information in PMC

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