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Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004.
Pediatrics 2007; 119(4):e900-6Ped

Abstract

OBJECTIVE

Our goal was to determine trends in low birth weight and preterm birth among US infants born to HIV-infected women.

METHODS

We used data from the longitudinal Pediatric Spectrum of HIV Disease, a large HIV cohort, to assess trends in low birth weight and preterm birth from 1989 to 2004 among 11,321 study infants. Among women with prenatal care, we also assessed risk factors, including maternal antiretroviral therapy during pregnancy, that were predictive of low birth weight and preterm birth using univariate and multivariate logistic regression models.

RESULTS

Overall, 11,231 of 14,464 infants who were enrolled in Pediatric Spectrum of HIV Disease were tested during the neonatal period. From 1989 to 2004, testing increased from 32% to 97%. The proportion of HIV-exposed infants who had low birth weight decreased from 35% to 21% and occurred in all racial/ethnic groups. Prevalence of preterm birth decreased from 35% to 22% and occurred in all groups. Any maternal antiretroviral therapy use increased from 2% to 84%. Among 8793 women who had prenatal care, low birth weight was associated with a history of illicit maternal drug use, unknown maternal HIV status before delivery, symptomatic maternal HIV disease, black race, Hispanic ethnicity, and infant HIV infection. Antiretroviral therapy or lack of it was not associated with low birth weight. Among women with prenatal care, preterm birth was associated with a history of illicit maternal drug use, symptomatic maternal HIV disease, no antiretroviral therapy, receipt of a 3-drug highly active antiretroviral therapy regimen with protease inhibitors, black race, and infant HIV infection.

CONCLUSIONS

The proportion of infants who had low birth weight or were born preterm declined during an era of increased maternal antiretroviral therapies. These Pediatric Spectrum of HIV Disease trends differ from the overall increases in both outcomes among the US population.

Authors+Show Affiliations

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jzs1@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17353299

Citation

Schulte, Joann, et al. "Declines in Low Birth Weight and Preterm Birth Among Infants Who Were Born to HIV-infected Women During an Era of Increased Use of Maternal Antiretroviral Drugs: Pediatric Spectrum of HIV Disease, 1989-2004." Pediatrics, vol. 119, no. 4, 2007, pp. e900-6.
Schulte J, Dominguez K, Sukalac T, et al. Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004. Pediatrics. 2007;119(4):e900-6.
Schulte, J., Dominguez, K., Sukalac, T., Bohannon, B., & Fowler, M. G. (2007). Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004. Pediatrics, 119(4), pp. e900-6.
Schulte J, et al. Declines in Low Birth Weight and Preterm Birth Among Infants Who Were Born to HIV-infected Women During an Era of Increased Use of Maternal Antiretroviral Drugs: Pediatric Spectrum of HIV Disease, 1989-2004. Pediatrics. 2007;119(4):e900-6. PubMed PMID: 17353299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004. AU - Schulte,Joann, AU - Dominguez,Ken, AU - Sukalac,Thomas, AU - Bohannon,Beverly, AU - Fowler,Mary Glenn, AU - ,, Y1 - 2007/03/12/ PY - 2007/3/14/pubmed PY - 2007/4/24/medline PY - 2007/3/14/entrez SP - e900 EP - 6 JF - Pediatrics JO - Pediatrics VL - 119 IS - 4 N2 - OBJECTIVE: Our goal was to determine trends in low birth weight and preterm birth among US infants born to HIV-infected women. METHODS: We used data from the longitudinal Pediatric Spectrum of HIV Disease, a large HIV cohort, to assess trends in low birth weight and preterm birth from 1989 to 2004 among 11,321 study infants. Among women with prenatal care, we also assessed risk factors, including maternal antiretroviral therapy during pregnancy, that were predictive of low birth weight and preterm birth using univariate and multivariate logistic regression models. RESULTS: Overall, 11,231 of 14,464 infants who were enrolled in Pediatric Spectrum of HIV Disease were tested during the neonatal period. From 1989 to 2004, testing increased from 32% to 97%. The proportion of HIV-exposed infants who had low birth weight decreased from 35% to 21% and occurred in all racial/ethnic groups. Prevalence of preterm birth decreased from 35% to 22% and occurred in all groups. Any maternal antiretroviral therapy use increased from 2% to 84%. Among 8793 women who had prenatal care, low birth weight was associated with a history of illicit maternal drug use, unknown maternal HIV status before delivery, symptomatic maternal HIV disease, black race, Hispanic ethnicity, and infant HIV infection. Antiretroviral therapy or lack of it was not associated with low birth weight. Among women with prenatal care, preterm birth was associated with a history of illicit maternal drug use, symptomatic maternal HIV disease, no antiretroviral therapy, receipt of a 3-drug highly active antiretroviral therapy regimen with protease inhibitors, black race, and infant HIV infection. CONCLUSIONS: The proportion of infants who had low birth weight or were born preterm declined during an era of increased maternal antiretroviral therapies. These Pediatric Spectrum of HIV Disease trends differ from the overall increases in both outcomes among the US population. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17353299/Declines_in_low_birth_weight_and_preterm_birth_among_infants_who_were_born_to_HIV_infected_women_during_an_era_of_increased_use_of_maternal_antiretroviral_drugs:_Pediatric_Spectrum_of_HIV_Disease_1989_2004_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=17353299 DB - PRIME DP - Unbound Medicine ER -