Birth weight and preterm delivery outcomes of perinatally vs nonperinatally human immunodeficiency virus-infected pregnant women in the United States: Results from the PHACS SMARTT study and IMPAACT P1025 protocol

Jennifer Jao, Deborah Kacanek, Paige L. Williams, Mitchell E. Geffner, Elizabeth G. Livingston, Rhoda S. Sperling, Kunjal Patel, Arlene D. Bardeguez, Sandra K. Burchett, Nahida Chakhtoura, Gwendolyn B Scott, Russell B. Van Dyke, Elaine J. Abrams

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background. Pregnancy outcomes of perinatally human immunodeficiency virus-infected women (PHIV) are poorly defined. Methods. We compared preterm delivery and birth weight (BW) outcomes (low BW [LBW], <2500 g), small-for-gestational-Age [SGA], and BW z scores [BWZ]) in HIV-exposed uninfected infants of PHIV vs nonperinatally HIV-infected (NPHIV) pregnant women in the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities or International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 studies. Mixed effects models and log binomial models were used to assess the association of maternal PHIV status with infant outcomes. Age-stratified analyses were performed. Results. From 1998 to 2013, 2270 HIV-infected pregnant women delivered 2692 newborns (270 born to PHIV and 2422 to NPHIV women). PHIV women were younger, (mean age 21 vs 25 years, P < .01) and more likely to have a pregnancy CD4 count <200 cells/mm3 (19% vs 11%, P = .01). No associations between maternal PHIV status and preterm delivery, SGA, or LBW were observed. After adjustment, BWZ was 0.12 lower in infants of PHIV vs NPHIV women (adjusted mean, -0.45 vs -0.33; P = .04). Among women aged 23-30 years (n = 1770), maternal PHIV was associated with LBW (aRR = 1.74; 95% confidence interval, 1.18, 2.58; P < .01). Conclusion. The overall lack of association between maternal PHIV status and preterm delivery or infant BW outcomes is reassuring. The higher rates of LBW observed in PHIV women aged 23-30 years warrants further mechanism-based investigations as this is a rapidly growing and aging population worldwide.

Original languageEnglish (US)
Pages (from-to)982-989
Number of pages8
JournalClinical Infectious Diseases
Volume65
Issue number6
DOIs
StatePublished - Sep 15 2017

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Birth Weight
Pregnant Women
HIV
Women's Rights
Mothers
Gestational Age
Acquired Immunodeficiency Syndrome
Pediatrics
Premature Birth
Low Birth Weight Infant
Statistical Models
Pregnancy Outcome
CD4 Lymphocyte Count
Cohort Studies

Keywords

  • Birth weight
  • Perinatal HIV infection
  • Pregnancy
  • Preterm delivery

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Birth weight and preterm delivery outcomes of perinatally vs nonperinatally human immunodeficiency virus-infected pregnant women in the United States : Results from the PHACS SMARTT study and IMPAACT P1025 protocol. / Jao, Jennifer; Kacanek, Deborah; Williams, Paige L.; Geffner, Mitchell E.; Livingston, Elizabeth G.; Sperling, Rhoda S.; Patel, Kunjal; Bardeguez, Arlene D.; Burchett, Sandra K.; Chakhtoura, Nahida; Scott, Gwendolyn B; Van Dyke, Russell B.; Abrams, Elaine J.

In: Clinical Infectious Diseases, Vol. 65, No. 6, 15.09.2017, p. 982-989.

Research output: Contribution to journalArticle

Jao, J, Kacanek, D, Williams, PL, Geffner, ME, Livingston, EG, Sperling, RS, Patel, K, Bardeguez, AD, Burchett, SK, Chakhtoura, N, Scott, GB, Van Dyke, RB & Abrams, EJ 2017, 'Birth weight and preterm delivery outcomes of perinatally vs nonperinatally human immunodeficiency virus-infected pregnant women in the United States: Results from the PHACS SMARTT study and IMPAACT P1025 protocol', Clinical Infectious Diseases, vol. 65, no. 6, pp. 982-989. https://doi.org/10.1093/cid/cix488
Jao, Jennifer ; Kacanek, Deborah ; Williams, Paige L. ; Geffner, Mitchell E. ; Livingston, Elizabeth G. ; Sperling, Rhoda S. ; Patel, Kunjal ; Bardeguez, Arlene D. ; Burchett, Sandra K. ; Chakhtoura, Nahida ; Scott, Gwendolyn B ; Van Dyke, Russell B. ; Abrams, Elaine J. / Birth weight and preterm delivery outcomes of perinatally vs nonperinatally human immunodeficiency virus-infected pregnant women in the United States : Results from the PHACS SMARTT study and IMPAACT P1025 protocol. In: Clinical Infectious Diseases. 2017 ; Vol. 65, No. 6. pp. 982-989.
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abstract = "Background. Pregnancy outcomes of perinatally human immunodeficiency virus-infected women (PHIV) are poorly defined. Methods. We compared preterm delivery and birth weight (BW) outcomes (low BW [LBW], <2500 g), small-for-gestational-Age [SGA], and BW z scores [BWZ]) in HIV-exposed uninfected infants of PHIV vs nonperinatally HIV-infected (NPHIV) pregnant women in the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities or International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 studies. Mixed effects models and log binomial models were used to assess the association of maternal PHIV status with infant outcomes. Age-stratified analyses were performed. Results. From 1998 to 2013, 2270 HIV-infected pregnant women delivered 2692 newborns (270 born to PHIV and 2422 to NPHIV women). PHIV women were younger, (mean age 21 vs 25 years, P < .01) and more likely to have a pregnancy CD4 count <200 cells/mm3 (19{\%} vs 11{\%}, P = .01). No associations between maternal PHIV status and preterm delivery, SGA, or LBW were observed. After adjustment, BWZ was 0.12 lower in infants of PHIV vs NPHIV women (adjusted mean, -0.45 vs -0.33; P = .04). Among women aged 23-30 years (n = 1770), maternal PHIV was associated with LBW (aRR = 1.74; 95{\%} confidence interval, 1.18, 2.58; P < .01). Conclusion. The overall lack of association between maternal PHIV status and preterm delivery or infant BW outcomes is reassuring. The higher rates of LBW observed in PHIV women aged 23-30 years warrants further mechanism-based investigations as this is a rapidly growing and aging population worldwide.",
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T1 - Birth weight and preterm delivery outcomes of perinatally vs nonperinatally human immunodeficiency virus-infected pregnant women in the United States

T2 - Results from the PHACS SMARTT study and IMPAACT P1025 protocol

AU - Jao, Jennifer

AU - Kacanek, Deborah

AU - Williams, Paige L.

AU - Geffner, Mitchell E.

AU - Livingston, Elizabeth G.

AU - Sperling, Rhoda S.

AU - Patel, Kunjal

AU - Bardeguez, Arlene D.

AU - Burchett, Sandra K.

AU - Chakhtoura, Nahida

AU - Scott, Gwendolyn B

AU - Van Dyke, Russell B.

AU - Abrams, Elaine J.

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N2 - Background. Pregnancy outcomes of perinatally human immunodeficiency virus-infected women (PHIV) are poorly defined. Methods. We compared preterm delivery and birth weight (BW) outcomes (low BW [LBW], <2500 g), small-for-gestational-Age [SGA], and BW z scores [BWZ]) in HIV-exposed uninfected infants of PHIV vs nonperinatally HIV-infected (NPHIV) pregnant women in the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities or International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 studies. Mixed effects models and log binomial models were used to assess the association of maternal PHIV status with infant outcomes. Age-stratified analyses were performed. Results. From 1998 to 2013, 2270 HIV-infected pregnant women delivered 2692 newborns (270 born to PHIV and 2422 to NPHIV women). PHIV women were younger, (mean age 21 vs 25 years, P < .01) and more likely to have a pregnancy CD4 count <200 cells/mm3 (19% vs 11%, P = .01). No associations between maternal PHIV status and preterm delivery, SGA, or LBW were observed. After adjustment, BWZ was 0.12 lower in infants of PHIV vs NPHIV women (adjusted mean, -0.45 vs -0.33; P = .04). Among women aged 23-30 years (n = 1770), maternal PHIV was associated with LBW (aRR = 1.74; 95% confidence interval, 1.18, 2.58; P < .01). Conclusion. The overall lack of association between maternal PHIV status and preterm delivery or infant BW outcomes is reassuring. The higher rates of LBW observed in PHIV women aged 23-30 years warrants further mechanism-based investigations as this is a rapidly growing and aging population worldwide.

AB - Background. Pregnancy outcomes of perinatally human immunodeficiency virus-infected women (PHIV) are poorly defined. Methods. We compared preterm delivery and birth weight (BW) outcomes (low BW [LBW], <2500 g), small-for-gestational-Age [SGA], and BW z scores [BWZ]) in HIV-exposed uninfected infants of PHIV vs nonperinatally HIV-infected (NPHIV) pregnant women in the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities or International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 studies. Mixed effects models and log binomial models were used to assess the association of maternal PHIV status with infant outcomes. Age-stratified analyses were performed. Results. From 1998 to 2013, 2270 HIV-infected pregnant women delivered 2692 newborns (270 born to PHIV and 2422 to NPHIV women). PHIV women were younger, (mean age 21 vs 25 years, P < .01) and more likely to have a pregnancy CD4 count <200 cells/mm3 (19% vs 11%, P = .01). No associations between maternal PHIV status and preterm delivery, SGA, or LBW were observed. After adjustment, BWZ was 0.12 lower in infants of PHIV vs NPHIV women (adjusted mean, -0.45 vs -0.33; P = .04). Among women aged 23-30 years (n = 1770), maternal PHIV was associated with LBW (aRR = 1.74; 95% confidence interval, 1.18, 2.58; P < .01). Conclusion. The overall lack of association between maternal PHIV status and preterm delivery or infant BW outcomes is reassuring. The higher rates of LBW observed in PHIV women aged 23-30 years warrants further mechanism-based investigations as this is a rapidly growing and aging population worldwide.

KW - Birth weight

KW - Perinatal HIV infection

KW - Pregnancy

KW - Preterm delivery

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