Cardiac structure and function in fetuses of mothers infected with HIV: The prospective (PCHIV)-C-2-H-2 multicenter study

Background This study was designed to determine ii vertically transmitted H IV infection and maternal injection with HIV are associated with altered ca rdiovascular structure and function in utero. Methods Fetal achocardioaraphy was performed in 173 fetuses of 169 HIV-infe cted mothers (mean gestational age, 33.0 weeks; SD = 3.7 weeks) at 5 center s. Biparietal diameter, femur length, cardiovascular dimensions, and Dopple r velocities through atrioventricular and semilunar valves and the umbilica l artery were measured. Measurements were converted to z scores based on pu blished normal data. Results Fetuses determined after birth to be HIV-infected had similar echoc ordiogrophic findings as fetuses later determined to be HIV-uninfected exce pt for slightly smaller left ventricular diastolic dimensions (P= .01). The femur length (P= .03) was also smaller in the fetuses postnatally identifi ed as HIV-infected. Differences in cardiovascular dimensions and Doppler ve locities were identified between fetuses of HIV-infected women and previous ly published normal fetal data. The reason For the differences may be a res ult of maternal HIV infection, maternal risk factors, or selection bias in the external control data. Conclusions Vertically transmitted HIV infection may be associated with red uced left ventricular size but not with altered cardiac function in utero. Fetuses of HIV-infected mothers may have abnormal cardiovascular structure and function and increased placental vascular resistance, regardless of whe ther the fetuses are subsequently found to be infected with HIV.