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 language | English |
|---|---|
| Pages (from-to) | 1389-1399 |
| Number of pages | 11 |
| Journal | AIDS |
| Volume | 14 |
| Issue number | 10 |
| DOIs | |
| State | Published - Jul 28 2000 |
| Externally published | Yes |
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Keywords
- Antiretroviral therapy
- HIV
- Intrauterine growth retardation
- Low birth weight
- Pregnancy
- Preterm birth
- Vertical infection
- Zidovudine
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
Cite this
Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine. / Lambert, John S.; Watts, D. Heather; Mofenson, Lynne; Stiehm, E. Richard; Harris, D. Robert; Bethel, James; Whitehouse, Jean; Jimenez, Eleanor; Gandia, Jorge; Scott, Gwendolyn B; O'Sullivan, Mary Jo; Kovacs, Andrea; Stek, Alice; Shearer, William T.; Hammill, Hunter; Van Dyke, Russell; Maupin, Robert; Silio, Maggie; Fowler, Mary Glenn.
In: AIDS, Vol. 14, No. 10, 28.07.2000, p. 1389-1399.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine
AU - Lambert, John S.
AU - Watts, D. Heather
AU - Mofenson, Lynne
AU - Stiehm, E. Richard
AU - Harris, D. Robert
AU - Bethel, James
AU - Whitehouse, Jean
AU - Jimenez, Eleanor
AU - Gandia, Jorge
AU - Scott, Gwendolyn B
AU - O'Sullivan, Mary Jo
AU - Kovacs, Andrea
AU - Stek, Alice
AU - Shearer, William T.
AU - Hammill, Hunter
AU - Van Dyke, Russell
AU - Maupin, Robert
AU - Silio, Maggie
AU - Fowler, Mary Glenn
PY - 2000/7/28
Y1 - 2000/7/28
N2 - 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.
AB - 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.
KW - Antiretroviral therapy
KW - HIV
KW - Intrauterine growth retardation
KW - Low birth weight
KW - Pregnancy
KW - Preterm birth
KW - Vertical infection
KW - Zidovudine
UR - http://www.scopus.com/inward/record.url?scp=0033941736&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033941736&partnerID=8YFLogxK
U2 - 10.1097/00002030-200007070-00012
DO - 10.1097/00002030-200007070-00012
M3 - Article
VL - 14
SP - 1389
EP - 1399
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 10
ER -