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Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection.
AIDS. 1995 Jul; 9(7):721-6.AIDS

Abstract

OBJECTIVES

To examine the relationship between maternal HIV infection, placental malaria infection, and infant mortality as a first step in investigating the possibility of increased vertical transmission of HIV due to placental malaria infection.

DESIGN

Retrospective analysis of data from a cohort study of mothers and infants in rural Malawi conducted from 1987 to 1990.

METHODS

Pregnant women in Malawi were enrolled in a study examining chemoprophylaxis during pregnancy. At delivery, placental malaria infection status was determined. Infants born into this study were visited every 2 months for the first 2-3 years of life. Deaths were investigated using a standardized 'verbal autopsy' interview. Maternal serum collected during pregnancy was tested for antibodies to HIV-1 by enzyme-linked immunosorbent assay with Western blot confirmation.

RESULTS

Overall, 138 (5.3%) of 2608 women in the study were HIV-1-seropositive. Infant mortality rates were 144 and 235 per 1000 live births for children born to HIV-seronegative and HIV-seropositive women, respectively (P < 0.001). In a multivariate model, the odds of dying during the post-neonatal period for an infant born to a mother with both placental malaria and HIV infection was 4.5 times greater than an infant born to a mother with only placental malaria, and between 2.7 and 7.7 times greater (depending on birthweight) than an infant born to a mother with only HIV infection.

CONCLUSIONS

This study strongly suggests that exposure to both placental malaria infection and maternal HIV infection increases post-neonatal mortality beyond the independent risk associated with exposure to either maternal HIV or placental malaria infection. If confirmed, malaria chemoprophylaxis during pregnancy could decrease the impact of transmission of HIV from mother to infant.

Authors+Show Affiliations

Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

7546417

Citation

Bloland, P B., et al. "Maternal HIV Infection and Infant Mortality in Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection." AIDS (London, England), vol. 9, no. 7, 1995, pp. 721-6.
Bloland PB, Wirima JJ, Steketee RW, et al. Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection. AIDS. 1995;9(7):721-6.
Bloland, P. B., Wirima, J. J., Steketee, R. W., Chilima, B., Hightower, A., & Breman, J. G. (1995). Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection. AIDS (London, England), 9(7), 721-6.
Bloland PB, et al. Maternal HIV Infection and Infant Mortality in Malawi: Evidence for Increased Mortality Due to Placental Malaria Infection. AIDS. 1995;9(7):721-6. PubMed PMID: 7546417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection. AU - Bloland,P B, AU - Wirima,J J, AU - Steketee,R W, AU - Chilima,B, AU - Hightower,A, AU - Breman,J G, PY - 1995/7/1/pubmed PY - 1995/7/1/medline PY - 1995/7/1/entrez KW - Africa KW - Africa South Of The Sahara KW - Biology KW - Birth Weight KW - Body Weight KW - Case Control Studies KW - Demographic Factors KW - Developing Countries KW - Diseases KW - Eastern Africa KW - English Speaking Africa KW - Family And Household KW - Family Characteristics KW - Family Relationships KW - Hiv Infections--women KW - Infant Mortality KW - Malaria--women KW - Malawi KW - Mortality KW - Mothers KW - Parasitic Diseases KW - Parents KW - Physiology KW - Population KW - Population Characteristics KW - Population Dynamics KW - Pregnant Women KW - Research Methodology KW - Research Report KW - Retrospective Studies KW - Studies KW - Viral Diseases SP - 721 EP - 6 JF - AIDS (London, England) JO - AIDS VL - 9 IS - 7 N2 - OBJECTIVES: To examine the relationship between maternal HIV infection, placental malaria infection, and infant mortality as a first step in investigating the possibility of increased vertical transmission of HIV due to placental malaria infection. DESIGN: Retrospective analysis of data from a cohort study of mothers and infants in rural Malawi conducted from 1987 to 1990. METHODS: Pregnant women in Malawi were enrolled in a study examining chemoprophylaxis during pregnancy. At delivery, placental malaria infection status was determined. Infants born into this study were visited every 2 months for the first 2-3 years of life. Deaths were investigated using a standardized 'verbal autopsy' interview. Maternal serum collected during pregnancy was tested for antibodies to HIV-1 by enzyme-linked immunosorbent assay with Western blot confirmation. RESULTS: Overall, 138 (5.3%) of 2608 women in the study were HIV-1-seropositive. Infant mortality rates were 144 and 235 per 1000 live births for children born to HIV-seronegative and HIV-seropositive women, respectively (P < 0.001). In a multivariate model, the odds of dying during the post-neonatal period for an infant born to a mother with both placental malaria and HIV infection was 4.5 times greater than an infant born to a mother with only placental malaria, and between 2.7 and 7.7 times greater (depending on birthweight) than an infant born to a mother with only HIV infection. CONCLUSIONS: This study strongly suggests that exposure to both placental malaria infection and maternal HIV infection increases post-neonatal mortality beyond the independent risk associated with exposure to either maternal HIV or placental malaria infection. If confirmed, malaria chemoprophylaxis during pregnancy could decrease the impact of transmission of HIV from mother to infant. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/7546417/Maternal_HIV_infection_and_infant_mortality_in_Malawi:_evidence_for_increased_mortality_due_to_placental_malaria_infection_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=7546417.ui DB - PRIME DP - Unbound Medicine ER -