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The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 158-169页

作者： Traoré Youssouf Téguété Ibrahima Dicko Fatoumata Traoré Bocoum Amadou Fané Seydou Traoré Tidiani Traoré Mamadou Salia Dao Seydou Touré Moustapha varol nesrin Dolo Amadou Department of Gynaecology and Obstétrics Gabriel TOURE Teaching Hospital Bamako Mali Department of Pediatics Gabriel TOURE Teaching Hospital Bamako Mali Department of Gynaecology and Obstétrics Regional Hospital of Segou Bamako Mali Department of Gynaecology and Obstétrics Point G Teaching Hospital Bamako Mali Motherhood Unit of “Csref Commune II” Bamako Mali Department of Gynaecology and Obstétrics “Hopital du Mali” Teaching Hospital Bamako Mali Sydney Gynaecology & Endometriosis Centre Sydney Medical School The University of Sydney Sydney Australia

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0

关键词： Low Birth Weight Human Immunodeficiency Virus Infection Mother to Child Transmission Newborn Death Mali

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