Background: It is yet a controversy subject whether low birth weight and infant\ndeath are associated to human immunodeficiency virus-1 infection. Objective:\nTo appreciate association between low birth weights, mother to child\nHIV transmission and infant mortality in HIV-1 infected pregnant women\ndelivering between 2011 and 2016. Materials: We conducted 6 years cohort\nstudy in urban Mali. Outcome included preterm delivery, small for gestational\nage, infant survival status and HIV transmission. Comparison concerned\nwomen clinical WHO stage, mother viro-immunological status, and newborn\nanthropometric parameters. Results: HIV-1 infected women who delivered\nlow birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546)\nin HIV negative patients (p=0.016). CD4 T cell counts low than 350 T cells\ncount were strongly associated to LBW (p=0.000; RR=3.03; 95% CI [1.89 -\n3.16]). There is no significant association between ART that was initiated\nduring pregnancy (p=0.061, RR=0.02; CI 95% (1.02 - 1.99)) or during delivery\n(p=0.571; RR=1.01; CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate\nanalysis ART regimens containing protease inhibitor (PI) were lone\nregimens associated with LBW ((p=0.030; RR=1.001; 95% confidence interval\n[1.28 - 3.80]). Very low birth weight was statistically associated to\nwomen HIV infection (adjusted relative risk, 2.02; p=0.000; 95% confidence\ninterval (2.17 - 4.10)). There is no significant difference between mother to\nchild HIV transmission rate in the two HIV-infected pregnant women (10\ninfected children in group 2: MTCT rate 4.5%) and 3 infected children in\ngroup 1 (MTCT rate: 2.7%) (p=0.56; RR, 0.59; CI 95% (0.18 - 4.39)). In multivariate\nanalysis, LBW was associated with infant death (p=0.001; RR =\n2.04; CI 95% [1.04 - 5.05]). The median weight of infant at the moment of\ndeath in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was\nfound between infant death among LBW newborn with mother WHO stage 2\n(p=0.004; adjusted RR=3.22; CI 95% [2.25 - 6.00]), CD4 T cells count < 350\ncells/mm3 (p=0.005; RR=2.81; CI 95% [1.20 - 4.11]), PI regimens (p =\n0.030; RR=1.00; CI 95% [1.28 - 3.80]). Conclusion: We confirm increased\nrisk of low birth weight and mother HIV-1 infection and we identified\nstrongest association between mortality in infant born to HIV-1 infected\nmother and LBW.
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