Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine

John S. Lambert, D. Heather Watts, Lynne Mofenson, E. Richard Stiehm, D. Robert Harris, James Bethel, Jean Whitehouse, Eleanor Jimenez, Jorge Gandia, Gwen Scott, Mary Jo O'Sullivan, Andrea Kovacs, Alice Stek, William T. Shearer, Hunter Hammill, Russell Van Dyke, Robert Maupin, Maggie Silio, Mary Glenn Fowler

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Objective: To evaluate independent contributions of maternal factors to adverse pregnancy outcomes (APO) in HIV-infected women receiving antiretroviral therapy (ART). Design: Risk factors for preterm birth (< 37 weeks gestation), low birth weight (LBW) (< 2500 g), and intrauterine growth retardation (IUGR) (birth weight < 10(th) percentile for gestational age) examined in 497 HIV-infected pregnant women enrolled in PACTG 185, a perinatal clinical trial. Methods: HIV RNA copy number, culture titer, and CD4 lymphocyte counts were measured during pregnancy. Information collected included antenatal use of cigarettes, alcohol, illicit drugs; ART; obstetric history and complications. Results: Eighty-six percent were minority race/ethnicity; 86% received antenatal monotherapy, predominantly zidovudine (ZDV), and 14% received combination antiretrovirals. Preterm birth occurred in 17%, LBW in 13%, IUGR in 6%. Risk of preterm birth was independently associated with prior preterm birth [odds ratio (OR) 3.34; P < 0.001], multiple gestation (OR, 6.02; P = 0.011), antenatal alcohol use (OR, 1.91; P = 0.038), and antenatal diagnosis of genital herpes (OR, 0.24; P = 0.022) or pre-eclampsia (OR, 6.36; P = 0.025). LBW was associated with antenatal diagnosis of genital herpes (OR, 0.08; P = 0.014) and pre-eclampsia (OR, 5.25; P = 0.049), and baseline HIV culture titer (OR, 1.41; P = 0.037). IUGR was associated with multiple gestation (OR, 8.20; P = 0.010), antenatal cigarette use (OR, 3.60; P = 0.008), and pre-eclampsia (OR, 12.90; P = 0.007). Maternal immune status and HIV RNA copy number were not associated with APO. Conclusions: Risk factors for APO in antiretroviral treated HIV-infected women are similar to those reported for uninfected women. These data suggest that provision of prenatal care and ART may reduce APO. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish (US)
Pages (from-to)1389-1399
Number of pages11
JournalAIDS
Volume14
Issue number10
DOIs
StatePublished - 2000

Keywords

  • Antiretroviral therapy
  • HIV
  • Intrauterine growth retardation
  • Low birth weight
  • Pregnancy
  • Preterm birth
  • Vertical infection
  • Zidovudine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Lambert, J. S., Watts, D. H., Mofenson, L., Stiehm, E. R., Harris, D. R., Bethel, J., Whitehouse, J., Jimenez, E., Gandia, J., Scott, G., O'Sullivan, M. J., Kovacs, A., Stek, A., Shearer, W. T., Hammill, H., Van Dyke, R., Maupin, R., Silio, M., & Fowler, M. G. (2000). Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine. AIDS, 14(10), 1389-1399. https://doi.org/10.1097/00002030-200007070-00012