Background: Few studies have assessed the determinants of birthweight in newborns from HIV-positive mothers in analyses that adjusted for different gestational age at delivery. Method: We calculated gestational age-adjusted birthweightZ-score values in a national series of 600 newborns from women with HIV and in 600 newborns from HIV-negative women matched for gender and gestational age. The determinants of Z-score values in newborns from HIV-positive mothers were assessed in univariate and multivariate regression analyses. Results: Compared to newborns from HIV-negative women, newborns from HIV-positive women had significantly lower absolute birthweight (2799 vs. 2887 g;p=.007) and birthweightZscore (-0.430 vs. -0.222; p <.001). Among newborns from mothers with HIV, the maternal characteristics associated with significantly lower Z-score values in univariate analyses were recent substance use (Z-score difference [ZSD] 0.612, 95% CI 0.359-0.864, p <.001), smoking >10 cigarettes/day (ZSD 0.323, 95% CI 0.129-0.518, p=.001), absence of pregnancies in the past (ZSD 0.200, 95% CI 0.050-0.349, p=.009), no antiretroviral treatment in the past (ZSD 0.186, 95% CI 0.044-0.327, p=.010), and Caucasian ethnicity compared to Hispanic (ZSD 0.248, 95% CI 0.022-0.475, p=.032). Body mass index (BMI) at conception and maternal glycemia levels during pregnancy were also significantly related to birthweight Z scores. Glycemia, BMI, and recent substance use maintained a significant association with Z-score values in multivariate analyses. In the multivariate analysis, the only factors significantly associated with Z-score values below the 10th percentile were recent substance use (adjusted odds ratio [AOR] 3.17, 95% CI 1.15-8.74) and smoking (AOR 2.26, 95% CI 1.13-4.49). Discussion: We identified several factors associated with gestational age-adjusted birthweight in newborns from women with HIV Smoking and substance use have a significant negative impact on intrauterine growth, which adds to an independent HIV-related effect on birthweight. Prevention and information on this issue should be reinforced in women with HIV of childbearing age to reduce the risk of negative outcomes in their offspring.

Factors Influencing Gestational Age-Adjusted Birthweight in a National Series of 600 Newborns from Mothers with HIV / Marco, Floridia; Marina, Ravizza; Anna, Bucceri; Luisella, Lazier; Alessandra, Vigano; Salvatore, Alberico; Giovanni, Guaraldi; Gianfranco, Anzidei; Brunella, Guerra; Angela, Citernesi; Matilde, Sansone; Silvia, Baroncelli; Enrica, Tamburrini; Italian, ; Anceschi, Maurizio Marco; Massetti, Anna Paola. - In: HIV CLINICAL TRIALS. - ISSN 1528-4336. - 9:5(2008), pp. 287-297. [10.1310/hct0905-287]

Factors Influencing Gestational Age-Adjusted Birthweight in a National Series of 600 Newborns from Mothers with HIV

ANCESCHI, Maurizio Marco;MASSETTI, Anna Paola
2008

Abstract

Background: Few studies have assessed the determinants of birthweight in newborns from HIV-positive mothers in analyses that adjusted for different gestational age at delivery. Method: We calculated gestational age-adjusted birthweightZ-score values in a national series of 600 newborns from women with HIV and in 600 newborns from HIV-negative women matched for gender and gestational age. The determinants of Z-score values in newborns from HIV-positive mothers were assessed in univariate and multivariate regression analyses. Results: Compared to newborns from HIV-negative women, newborns from HIV-positive women had significantly lower absolute birthweight (2799 vs. 2887 g;p=.007) and birthweightZscore (-0.430 vs. -0.222; p <.001). Among newborns from mothers with HIV, the maternal characteristics associated with significantly lower Z-score values in univariate analyses were recent substance use (Z-score difference [ZSD] 0.612, 95% CI 0.359-0.864, p <.001), smoking >10 cigarettes/day (ZSD 0.323, 95% CI 0.129-0.518, p=.001), absence of pregnancies in the past (ZSD 0.200, 95% CI 0.050-0.349, p=.009), no antiretroviral treatment in the past (ZSD 0.186, 95% CI 0.044-0.327, p=.010), and Caucasian ethnicity compared to Hispanic (ZSD 0.248, 95% CI 0.022-0.475, p=.032). Body mass index (BMI) at conception and maternal glycemia levels during pregnancy were also significantly related to birthweight Z scores. Glycemia, BMI, and recent substance use maintained a significant association with Z-score values in multivariate analyses. In the multivariate analysis, the only factors significantly associated with Z-score values below the 10th percentile were recent substance use (adjusted odds ratio [AOR] 3.17, 95% CI 1.15-8.74) and smoking (AOR 2.26, 95% CI 1.13-4.49). Discussion: We identified several factors associated with gestational age-adjusted birthweight in newborns from women with HIV Smoking and substance use have a significant negative impact on intrauterine growth, which adds to an independent HIV-related effect on birthweight. Prevention and information on this issue should be reinforced in women with HIV of childbearing age to reduce the risk of negative outcomes in their offspring.
2008
antiretroviral treatment; birthweight; hiv; iugr; newborn; pregnancy; smoking; substance use
01 Pubblicazione su rivista::01a Articolo in rivista
Factors Influencing Gestational Age-Adjusted Birthweight in a National Series of 600 Newborns from Mothers with HIV / Marco, Floridia; Marina, Ravizza; Anna, Bucceri; Luisella, Lazier; Alessandra, Vigano; Salvatore, Alberico; Giovanni, Guaraldi; Gianfranco, Anzidei; Brunella, Guerra; Angela, Citernesi; Matilde, Sansone; Silvia, Baroncelli; Enrica, Tamburrini; Italian, ; Anceschi, Maurizio Marco; Massetti, Anna Paola. - In: HIV CLINICAL TRIALS. - ISSN 1528-4336. - 9:5(2008), pp. 287-297. [10.1310/hct0905-287]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/230698
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 10
social impact