TY - JOUR
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.
N1 - Funding Information:
CRS; 4101 Columbia IMPAACT CRS (Alice Higgins, Gina Silva, Sreedhar Gaddipati); 4201 University of Miami Pediatric/ Perinatal HIV/AIDS CRS; 4601 UCSD Maternal, Child, and Adolescent HIV CRS (Stephen A. Spector, Andrew Hull, Mary Caffery, Jean Manning); 4701 DUMC Pediatric CRS (Elizabeth Livingston, Margaret Donnelly, Joan Wilson, Julia Giner); 5003 Metropolitan Hospital NICHD CRS; 5009 Children’s Hospital of Boston NICHD CRS (Nancy Karthas, Lisa Tucker, Arlene Buck, Catherine Kneut); 5011 Boston Medical Center Pediatric HIV Program NICHD CRS; 5012 NYU NY NICHD CRS (Sandra Deygoo, Aditya Kaul, Maryam Minter, Siham Akleh, supported in part by grant UL1 TR000038 from the National Center for the Advancement of Translational Science (NCATS), National Institutes of Health); 5013 Jacobi Medical Center Bronx NICHD CRS; 5015 Children’s National Medical Center Washington DC NICHD CRS; 5017 Seattle Children’s Hospital CRS (Amanda Robson, Jane Hitti, Corry Venema-Weiss, Anna Klastorin); 5018 University of South Florida, Tampa NICHD CRS (Karen L. Bruder, Gail Lewis, Denise Casey); 5023 Washington Hospital Center NICHD CRS (Sara Parker, Rachel Scott, Patricia Tanjutco, Vanessa Emmanuel); 5031 San Juan City Hospital PR NICHD CRS (Antonio Mimoso, Rodrigo Diaz, Elvia Perez, Olga Pereira); 5040 SUNY Stony Brook NICHD CRS (Jennifer Griffin, Paul Ogburn); 5041 Children’s Hospital of Michigan NICHD CRS; 5044 Howard University Washington DC NICHD CRS; 5045 Harbor UCLA Medical Center NICHD CRS; 5048 University of Southern California, LA NICHD CRS (Alice Stek, Francoise Kramer, LaShonda Spencer, Andrea Kovacs); 5051 University of Florida College of Medicine, Jacksonville NICHD CRS (Mobeen Rathore, Isaac Delke, Geri Thomas, Barbara Millwood); 5052 University of Colorado, Denver NICHD CRS (Alisa Katai, Tara Kennedy, Kay Kinzie, Jenna Wallace, supported by NIH/ NCATS Colorado CTSI Grant Number UL1 TR000154); 5055 South Florida CDC, Ft Lauderdale NICHD CRS; 5083 Rush University Cook County Hospital, Chicago NICHD CRS (Julie Schmidt, Helen Cejtin, Maureen McNichols, Judith Senka); 5091 University of California, San Francisco NICHD CRS (Deborah Cohan; This publication was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH); 5092 Johns Hopkins University, Baltimore NCHD CRS (Jean Anderson, Eileen Sheridan-Malone); 5093 Miller Children’s Hospital Long Beach, CA NICHD CRS (Chritina Tolentino-Balbridge, Janielle Jackson-Alvarez, David Michalik, Jagmohan S. Batra); 5094 University of Maryland Baltimore NICHD CRS (Douglas Watson, Maria Johnson, Corinda Hilyard); 5095 Tulane University, New Orleans NICHD CRS (Robert Maupin, Chi Dola, Yvette Luster, Sheila Bradford); 5096 University of Alabama Birmingham NICHD CRS (Alan Tita, Micky Parks, Sharan Robbins); 6501 St. Jude/ UTHSC CRS (Edwin Thorpe, Jr., Katherine Knapp, Pamela Finnie, Nina Sublette); 6601 University of Puerto Rico Pediatric HIV/AIDS Research Program CRS (Carmen D. Zorrilla, Vivian Tamayo-Agrait); 6701 the Children’s Hospital of Philadelphia IMPAACT CRS; 6901 Bronx-Lebanon Hospital IMPAACT CRS (Rodney Wright); 7301 WNE Maternal Pediatric Adolescent AIDS CRS (Sharon Cormier, Katherine Luzuriaga, supported by CTSA Grant Number: 8UL1TR000161).
Funding Information:
Disclaimer. The conclusions and opinions expressed in this article are those of the authors and do not necessarily reflect those of the NIH or U.S. Department of Health and Human Services. The funding source played no role in this study analysis, the interpretation of data, the writing of the report, or in the decision to submit the paper for publication Financial support. J. J. is supported by NICHD (K23HD070760). PHACS is funded under cooperative agreements (HD052104, PHACS Coordinating Center, Tulane University School of Medicine; and HD052102, PHACS Data and Operations Center, Harvard T.H. Chan School of Public Health). IMPAACT is supported by NIAID (UM1AI068632, IMPAACT LOC, UM1AI068616, IMPAACT SDMC, and UM1AI106716, IMPAACT LC) with cofunding from NICHD and NIMH.
Funding Information:
PHACS was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with co-funding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases (NIAID), the Office of AIDS Research, the National Institute of Mental Health (NIMH), the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102) and the Tulane University School of Medicine (HD052104). Overall support for the IMPAACT Network was provided by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) under Award Numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC) and UM1AI106716 (IMPAACT LC), with co-funding from NICHD and NIMH.
PY - 2017/9/15
Y1 - 2017/9/15
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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U2 - 10.1093/cid/cix488
DO - 10.1093/cid/cix488
M3 - Article
C2 - 28575201
AN - SCOPUS:85031925055
VL - 65
SP - 982
EP - 989
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 6
ER -