Low birthweight in infants born to African HIV-infected women: Relationship with maternal body weight during pregnancy

The effect of maternal HIV infection on birthweight was estimated. In the p renatal clinic of the Centre Hospitalier de Kigali, HIV screening was propo sed to women with a gestational age (GA) of less than 28 weeks, HIV-infecte d (HIV+) and uninfected (HIV-) women were recruited, when they consented. A t inclusion, socioeconomic, obstetrical data, and body weight were collecte d, 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 de livery, birthweight, body length, and head circumference of the infant were documented. At inclusion and at the second follow-up visit, HIV+ women (N = 177) weighed 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 < 37 weeks, according to Finnstrom s core at birth), and intrauterine growth retardation (defined by LBW and GA greater than or equal to 37 weeks) were higher in infants born to HIV+ wome n than to HIV- women (p = 0.009, 0.01, and 0.053, respectively). In multiva riate logistic regression, the association between maternal HIV infection a nd LBW disappeared (p = 0.61), while low GA (p = 0.01) and low last prenata l weight (p = 0.01) were independant risk factors of LBW. LBW in infants bo rn to HIV+ women could be partly attributable to impaired maternal weight. These results underline the need for nutritional surveillance and dietary c ounselling, hoping to improve the prognosis of pregnancy in HIV+,women, reg ardless of other therapeutic interventions.