ASSOCIATION OF MATERNAL HIV-INFECTION WITH LOW-BIRTH-WEIGHT

We evaluated factors associated with low birth weight (LBW) in an HIV- infected cohort (n = 772) and a general sample (n = 2,377) of women de livering a live singleton in federal fiscal years 1989 and 1990 while enrolled in New York State Medicaid, The association of LBW and HIV in fection was studied in logistic models, controlling for illicit drug u se, demographic characteristics, adequacy of prenatal care, and medica l risk factors. Overall, 29% of the HIV-infected women had a LBW infan t, compared to 9.3% of the general sample (p < 0.001). The adjusted od ds of LBW for HIV-infected women were twofold higher than for uninfect ed women [odds ratio (OR) = 2.04 and 95% confidence interval (CI) = 1. 54, 2.69]. Odds of LBW were also increased for illicit drug users (OR = 2.16; 95% CI = 1.59, 2.94), cigarette smokers (OR = 1.81; 95% CI = 1 .37, 2.39), and African-American versus non-Hispanic white women (OR = 1.89; 95% CI = 1.31, 2.72). Lower odds appeared for women with adequa te prenatal care (OR = 0.54; 95% CI = 0.42, 0.68). Among only women wi th full-term deliveries, the association of HIV with LBW remained stro ng as we found nearly threefold greater odds of LBW for HIV-infected w omen. This study indicates that HIV-infected women have an increased r isk of bearing a LBW infant, even after adjusting for the effects of d rug use, health care delivery, and other social and medical risk facto rs.