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Journal of Tropical Pediatrics 1999 45(3):152-157; doi:10.1093/tropej/45.3.152
© 1999 by Oxford University Press
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Low birthweight in infants born to African HIV-infected women: relationship with maternal body weight during pregnancy

K CastetbonZ,ZZ, J LadnerZ,ZZZ, V LeroyZ, M ChauliacY, E KaritaY,Y, A De ClercqY,Y,Y, P Van de PerreY,Y, F DabisZ, Pregnancy and HIV Study Group (EGE)

Z INSERM U, 330, Université Victor Segalen-Bordeaux 2, Bordeaux, France ZZ Centre ORSTOM Petit Bassam, Abidjan, Côte d'Ivoire ZZZ Medical Information Unit, Centre Hospitalier de Kigali (CHK), Kigali, Rwanda Y CIDEF, Château de Longchamp, Paris, France AIDS Reference Laboratory, National AIDS Control Program, Kigali, Rwanda Department of Gynaecology and Obstetrics, CHK, Kigali, Rwanda

The effect of maternal HIV infection on birthweight was estimated. In the prenatal clinic of the Centre Hospitalier de Kigali, HIV screening was proposed to women with a gestational age (GA) of less than 28 weeks. HIV-infected (HIV+) and uninfected (HIF-) women were recruited, when they consented. At inclusion, socioeconomic, obstetrical data, and body weight were collected a clinical examination was performed, and tests for sexually transmitted diseases (STDs) and malaria were performed. Two prenatal visits were made, at 28-32 and 32-36 weeks, with clinical data and weight measurement. At delivery, birthweight, body length, and head circumference of the infant were documented. At inclusion and at the second follow-up visit, HIV+ women (N = 177) weighted less than HIV- women (N = 194) (p = 0.004). Mean birthweight in infants born to HIV+ women was 2947 g (SD = 429) and 3104 g (SD = 461) in infants born to HIV- women (p = 0.001). Frequencies of low birthweight (LBW, weight <2500 g), prematurity (GA <27 weeks, according to Finnström score at birth), and intrauterine growth retardation (defined by LBW and GA ≥37 weeks) were higher in infants born to HIV+ women than to HIV- women (p = 0.009, 0.01, and 0.053, respectively). In multivariate logistic regression, the association between maternal HIV infection and LBW disappeared (p = 0.61), while low GA (p = 0.01) and low last prenatal weight (p = 0.01) were independant risk factors of LBW. LBW in infants born to HIV+ women could be partly attributable to impaired maternal weight. These results underline the need for nutritional surveillance and dietary counselling, hoping to improve the prognosis of pregnancy in HIV+ women, regardless of other therapeutic interventions.


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