scholarly journals Assessing the Effects of Maternal HIV Infection on Pregnancy Outcomes using Cross-sectional Data in Malawi

2020 ◽  
Author(s):  
Halima Sumayya Twabi ◽  
Samuel O Manda ◽  
Dylan S Small
Keyword(s):  
Birth Weight ◽  
Hiv Infection ◽  
Perinatal Mortality ◽  
Pregnancy Outcomes ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Hiv Test ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Adverse Pregnancy

Abstract Background : Several studies have shown that maternal HIV infection is associated with adverse pregnancy outcomes such as low birth weight and perinatal mortality. However, the association is conflicted with the effect of antiretroviral therapy (ART) on the pregnancy outcomes and it remains unexamined. Using methods for matching possible confounders, the objectives of the study were to assess the effect of maternal HIV on birth weight and perinatal mortality and to investigate the effect of ART on these two pregnancy outcomes in HIV-infected women. Methods: Data on 4111 and 4759 children, born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys (MDHS) respectively, whose mothers had an HIV test result, were analysed. A best balancing method was chosen from a set of covariate balance methods namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting on the PS. HIV and ART data were only available in the MDHS 2010, permitting an assessment of the moderating effect of ART on the association between maternal HIV infection and birth weight and perinatal mortality. Results: In 2010, maternal HIV infection was negatively associated with birth weight (-25.3g, 95% CI:(-95.5, -7.4)) and in 2015-16 it was positively associated with birth weight (116.3g, 95 % CI:(27.8, 204.7)). Perinatal mortality was higher in infants of HIV-infected mothers compared to infants of HIV-uninfected mothers (OR = 1.5, 95% CI:(1.1 - 3.1)) in 2010, while there was no difference in the rate in 2015-16 (OR = 1.0, 95% CI:(0.4, 1.6)). ART was not associated with birth weight, however, it was associated with perinatal mortality (OR=3.9, 95% CI:(1.1, 14.8)). Conclusion: The study has found that maternal HIV infection had an adverse effect on birth weight and perinatal mortality in 2010. Birth weight was not dependent on ART uptake but perinatal mortality was higher among infants of HIV-infected mothers who were not on ART. The higher birth weight among HIV-infected mothers and similarity in perinatal mortality with HIV-uninfected mothers in 2015-16 may be indicative of successes of interventions within the PMTCT program in Malawi.

scholarly journals Impact of maternal HIV infection on pregnancy outcomes in southwestern China – a hospital registry based study

2019 ◽  
Vol 147 ◽  
Author(s):  
M. Yang ◽  
Y. Wang ◽  
Y. Chen ◽  
Y. Zhou ◽  
Q. Jiang
Keyword(s):  
Immune Deficiency ◽  
Hiv Infection ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Southwestern China ◽  
Hiv Positive ◽  
Rural Residence ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Adverse Pregnancy

AbstractGlobally, human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) continues to be a major public health issue. With improved survival, the number of people living with HIV/AIDS is increasing, with over 2 million among pregnant women. Investigating adverse pregnant outcomes of HIV-infected population and associated factors are of great importance to maternal and infant health. A cross-sectional data collected from hospital delivery records of 4397 mother–infant pairs in southwestern China were analysed. Adverse pregnant outcomes (including low birthweight/preterm delivery/low Apgar score) and maternal HIV status and other characteristics were measured. Two hundred thirteen (4.9%) mothers were HIV positive; maternal HIV infection, rural residence and pregnancy history were associated with all three indicators of adverse pregnancy outcomes. This research suggested that maternal population have high prevalence in HIV infection in this region. HIV-infected women had higher risks of experiencing adverse pregnancy outcomes. Rural residence predisposes adverse pregnancy outcomes. Findings of this study suggest social and medical support for maternal-infant care needed in this region, selectively towards rural areas and HIV-positive mothers.

scholarly journals Maternal HIV infection and risk of adverse pregnancy outcomes in Hunan province, China

Medicine ◽  
2020 ◽  
Vol 99 (8) ◽  
pp. e19213
Author(s):  
Huixia Li ◽  
Jiahui Liu ◽  
Danfeng Tan ◽  
Guangwen Huang ◽  
Jianfei Zheng ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Hunan Province ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Adverse Pregnancy

scholarly journals Obstetric and new born outcome in HIV infected pregnant women: a prospective cohort study in Bangalore Medical College Hospitals, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4445
Author(s):  
Rashmi S. Desai ◽  
Geetha Shivamurthy ◽  
Sameer Desai
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Opportunistic Infection ◽  
Prospective Cohort ◽  
Premature Rupture ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Cd4 Cell

Background: The effect of HIV on obstetric complications is known to vary across regions of world. The variation may be due to HIV infection per se or it may be due to complex interaction of related medical and social conditions that affect pregnancy. Incidence of these obstetric complications in HIV infected pregnant women is not well reported in India. So, this prospective cohort study was carried to observe the demographics and incidence of obstetrics complications like abortions, still birth, premature rupture of membranes, preterm delivery, opportunistic infections in HIV infected pregnant women.Methods: All pregnant women who were screened positive for HIV test, irrespective of their gestational age were included in the study. Apart from routine obstetric care, CD4 cell count was carried out. The patients were followed up till term, delivery and up to 6-week postpartum period. Obstetric outcomes like incidence of abortion, intrauterine death, preterm delivery and premature rupture of membrane were noted. Baby`s birth weight and the incidence of maternal opportunistic infection were noted and correlated with maternal CD4 cell count.Results: Maternal HIV infection is associated pre-term labour in 34.5%, PROM in 30%, low birth weight in 52.3%. Increased incidences of these adverse outcomes have an inverse relationship with CD4 count.Conclusions: Maternal HIV infection is associated with increased incidence of adverse obstetric outcome and opportunistic infection, and their incidences increase with lower CD4 count.

scholarly journals Causal Effect of Maternal HIV on Child Health Outcomes in the Context of Prevention of Mother to Child HIV Transmission (PMTCT) in Malawi

2019 ◽  
Author(s):  
Halima Sumayya Twabi ◽  
Samuel O Manda ◽  
Dylan S Small
Keyword(s):  
Birth Weight ◽  
Propensity Score ◽  
Hiv Infection ◽  
Exclusive Breastfeeding ◽  
Causal Effect ◽  
Mediating Effect ◽  
Pmtct Program ◽  
Hiv Status ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

Abstract Evidence has shown that maternal HIV infection has adverse effects on child birth weight. However, the effect of anti-retroviral therapy (ART) on pregnancy outcome is not conclusive. Ascertaining causality of these associations remain largely unexamined and untested, and if confirmed would help policy makers to improve implementation and sensitization of PMTCT program. However, assessing causal effect has been limited due to ethical concerns if randomized controlled trials are appropriate. We aim to estimate the causal effect of maternal HIV on birth weight and the causal effect of knowledge of HIV status on exclusive breastfeeding while ascertaining the mediating effect of ART using observational data. Data on over 18,000 and 16,000 children still alive and born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys were analysed. A set of methods for confounder balance namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting the propensity score (PS) were used. Before matching, place of residence, region, anaemia level and age were statistically different between HIV-infected and HIV-uninfected mothers for both the 2010 and 2015-16 data. After matching, the selected confounding variables were distributed similarly between HIV-infection statuses. Maternal HIV infection had a negative effect on infant birth weight for the 2010 data and had a positive effect on birth weight for the 2015-16 data with p-values <0.001. Uptake of ART did not mediate the effect of HIV infection on birth weight. Maternal knowledge of HIV status was not associated with behaviour concerning exclusive breastfeeding. We have found conflicting evidence on the association between maternal HIV infection and birth weight. The adverse association between maternal HIV infection and child birth weight found for the 2010 data could more likely be causal. However, the increased birth weight among infants born to HIV infected mothers in 2015-16 may show the recent successes of policies and interventions within the PMTCT program in Malawi. However, the purported mediating effect of ART on the association between HIV infection and birth weight was not found. Prenatal care interventions should continue to be supported among ANC clinics in Malawi.

scholarly journals Prevalence of food insecurity in pregnant women and its association with gestational weight gain pattern, neonatal birth weight, and pregnancy complications in Hamadan County, Iran, in 2018

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Farideh Kazemi ◽  
Seyedeh Zahra Masoumi ◽  
Arezoo Shayan ◽  
Seyedeh Zahra Shahidi Yasaghi
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Maternal Weight ◽  
Cross Sectional ◽  
Significance Level ◽  
Adverse Pregnancy

Abstract Background The results of some studies have indicated the association between food insecurity and certain adverse pregnancy outcomes. The present study aimed to investigate the prevalence of food insecurity in pregnant women and its association with pregnancy outcomes and complications. Methods The present cross-sectional study was conducted on 772 mothers who visited comprehensive health service centers during the first 10 days after delivery in 2018. The tools included the demographic and midwifery information questionnaire and an 18-item questionnaire devised by the U.S. Department of Agriculture. The significance level was considered to be 0.05. Results 67.5% of pregnant women had food insecurity. The multivariate analysis showed that birth weight decreased with the increase in the severity of food insecurity, but the reduction was not statistically significant. Based on the results, food insecurity had no statistically significant impact on the mothers’ weight gain pattern (p = 0.13). The risk of hypertension/preeclampsia and anemia was not related to food insecurity. Compared with the food-secure group, the probability of gestational diabetes was 56% lower in the food-insecure group without hunger and 61% lower in the food-insecure group with moderate hunger; however, in the food-insecure group with severe hunger, this probability was 1.5 times more than the food-secure group, which is not statistically significant. Conclusions The prevalence of food insecurity was high in pregnant women. Maternal weight gains during pregnancy and birth weight (despite being statistically insignificant) were affected by this condition; therefore, it is necessary to identify women with food insecurity on their first pregnancy visit; it is also crucial to take steps towards improving their health through allocating a family food basket and nutritional support for these women at least during pregnancy. Due to the limited sample size and inability to control the potential confounders, the association between food insecurity during pregnancy and the incidence of pregnancy complications could not be reached, hence the need for more studies.

scholarly journals An Exploration of Socio-demographic, Economic, and Environmental Factors in Black/White Disparities in Low Birth Weight Outcomes: A Cross-Sectional Study

2021 ◽  
Vol 21 (2) ◽  
pp. e00511-e00511
Author(s):  
Shondra Loggins Clay ◽  
Markisha J. Woodson ◽  
Renique Kersh
Keyword(s):  
Birth Weight ◽  
Environmental Factors ◽  
Public Housing ◽  
Racial Differences ◽  
Pregnancy Outcomes ◽  
Cross Sectional Study ◽  
Racial Groups ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adverse Pregnancy

Background: Numerous studies have been conducted to seek a better understanding of disparities in adverse pregnancy outcomes. The present study aimed to explore racial differences in influential socio-demographic, economic, and environmental factors in women who have had a low birth weight (LBW) infant (outcome variable). Study Design: A cross-sectional study. Methods: This study used data from the Fragile Families and Child Wellbeing Study (FFCWS). Univariate and multivariate analyses were performed. Results: The obtained results pointed to statistical racial differences between Non-Hispanic (NH) Black and NH White women in the socio-demographic variable of marital status (P<0.001). Regarding the assessed economic stability variables, employment status (P=0.032), poverty level (P<0.001), earnings (P=0.038), and federal government assistance paying for rent (P=0.007) were statistically significant across the two racial groups. The environmental factors that were statistically significant across racial groups were living in public housing projects (P=0.018), car ownership (P<0.001), and neighborhood safety (P=0.010). The results of the multivariate models revealed that NH Black race and government assistance to pay rent were associated with an increased likelihood of LBW, while being married, having health care coverage, and living in public housing were associated with a decreased likelihood. Conclusion: As evidenced by the obtained results, there were statistically significant racial differences in sociodemographic, economic, and environmental/physical characteristics associated with adverse pregnancy outcomes.

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