MATERNAL HUMAN-IMMUNODEFICIENCY-VIRUS-1 INFECTION AND INTRAUTERINE GROWTH - A PROSPECTIVE COHORT STUDY IN BUTARE, RWANDA

A prospective cohort study of 318 human immunodeficiency virus 1 (HIV- 1)-infected and 309 seronegative pregnant women was carried out in But are, Rwanda. Birth weight was significantly lower among singleton infa nts born alive to HIV-1-infected mothers compared with those born aliv e to seronegative mothers (2706 g vs. 2825 g; P = 0.002). Crown-to-hee l length, head circumference, chest circumference and placental weight were also reduced. Maternal HIV-1 infection was significantly associa ted with intrauterine growth retardation but not with preterm birth. D ifferences in the body mass index and weight/head ratio suggest that t he adverse impact on live born infants may have been most severe towar ds the end of pregnancy, resulting in a lean infant with a relatively large head. The higher frequency of intrauterine growth retardation co uld not be explained by potential confounding factors such as maternal cigarette smoking, history of sexually transmitted diseases or sociod emographic characteristics. The neonatal physical examination did not reveal any differences in clinical signs or symptoms within 48 hours o f birth except for the presence of conjunctivitis which was more commo n among infants of HIV-1-infected mothers. The perinatal and neonatal mortality rates were not significantly affected by maternal HIV-1 stat us.