Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda.
<h4>Introduction</h4>In utero exposure to HIV and/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adverse pregnancy outc...
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Public Library of Science (PLoS)
2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0329312 |
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| author | Natalia Zotova Athanase Munyaneza Gad Murenzi Gallican Kubwimana Adebola Adedimeji Kathryn Anastos Marcel Yotebieng CA-IeDEA consortium |
| author_facet | Natalia Zotova Athanase Munyaneza Gad Murenzi Gallican Kubwimana Adebola Adedimeji Kathryn Anastos Marcel Yotebieng CA-IeDEA consortium |
| author_sort | Natalia Zotova |
| collection | DOAJ |
| description | <h4>Introduction</h4>In utero exposure to HIV and/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adverse pregnancy outcomes among Rwandan women living with HIV (WLWH) and HIV-uninfected women and examines associations between HIV, ART timing, and LBW.<h4>Methods</h4>This retrospective cohort study used antenatal care, delivery, and PMTCT registry data from the Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA). Women with documented HIV status and recorded birth weights were included. Adverse outcomes were defined as LBW (<2,500 g), stillbirth, and preterm birth (<37 weeks gestation). Logistic regression was used to assess associations between maternal HIV status, ART timing, and LBW, adjusting for relevant covariates.<h4>Results and discussion</h4>Among 10,191 women with known HIV status and babies' birth weights, 12.7% (n = 1,293) were WLWH. There were 47 stillbirths (0.5%) and 70 preterm births (0.7%). Among 10,037 term births, 366 (3.6%) were LBW. WLWH had significantly higher rates of stillbirth (0.6% vs. 0.4%, p < 0.05) and LBW (6.5% vs. 2.9%, p < 0.001) compared to HIV-uninfected women; preterm birth rates did not differ significantly. The adjusted odds of LBW among WLWH were 1.61 (95% CI: 1.08, 2.39), controlling for marital status, primigravidae, and maternal weight at admission. Among WLWH (n = 1,274), ART initiation prior to pregnancy was associated with 50% lower odds of LBW after adjusting for age and WHO stage.<h4>Conclusions</h4>Even among relatively healthy uncomplicated pregnancies in low-risk delivery settings and universal ART, WLWH experienced significantly higher rates of stillbirth and LBW. Among WLWH, initiation of ART prior to current pregnancy had a protective effect against LBW. This underscores the importance of early HIV diagnosis and initiation of ART. |
| format | Article |
| id | doaj-art-4d264eb5a9854f07b8f2c6445db0663f |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
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| spelling | doaj-art-4d264eb5a9854f07b8f2c6445db0663f2025-08-23T05:32:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032931210.1371/journal.pone.0329312Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda.Natalia ZotovaAthanase MunyanezaGad MurenziGallican KubwimanaAdebola AdedimejiKathryn AnastosMarcel YotebiengCA-IeDEA consortium<h4>Introduction</h4>In utero exposure to HIV and/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adverse pregnancy outcomes among Rwandan women living with HIV (WLWH) and HIV-uninfected women and examines associations between HIV, ART timing, and LBW.<h4>Methods</h4>This retrospective cohort study used antenatal care, delivery, and PMTCT registry data from the Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA). Women with documented HIV status and recorded birth weights were included. Adverse outcomes were defined as LBW (<2,500 g), stillbirth, and preterm birth (<37 weeks gestation). Logistic regression was used to assess associations between maternal HIV status, ART timing, and LBW, adjusting for relevant covariates.<h4>Results and discussion</h4>Among 10,191 women with known HIV status and babies' birth weights, 12.7% (n = 1,293) were WLWH. There were 47 stillbirths (0.5%) and 70 preterm births (0.7%). Among 10,037 term births, 366 (3.6%) were LBW. WLWH had significantly higher rates of stillbirth (0.6% vs. 0.4%, p < 0.05) and LBW (6.5% vs. 2.9%, p < 0.001) compared to HIV-uninfected women; preterm birth rates did not differ significantly. The adjusted odds of LBW among WLWH were 1.61 (95% CI: 1.08, 2.39), controlling for marital status, primigravidae, and maternal weight at admission. Among WLWH (n = 1,274), ART initiation prior to pregnancy was associated with 50% lower odds of LBW after adjusting for age and WHO stage.<h4>Conclusions</h4>Even among relatively healthy uncomplicated pregnancies in low-risk delivery settings and universal ART, WLWH experienced significantly higher rates of stillbirth and LBW. Among WLWH, initiation of ART prior to current pregnancy had a protective effect against LBW. This underscores the importance of early HIV diagnosis and initiation of ART.https://doi.org/10.1371/journal.pone.0329312 |
| spellingShingle | Natalia Zotova Athanase Munyaneza Gad Murenzi Gallican Kubwimana Adebola Adedimeji Kathryn Anastos Marcel Yotebieng CA-IeDEA consortium Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. PLoS ONE |
| title | Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. |
| title_full | Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. |
| title_fullStr | Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. |
| title_full_unstemmed | Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. |
| title_short | Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda. |
| title_sort | low birth weight and adverse pregnancy outcomes among women living with hiv and hiv uninfected in rwanda |
| url | https://doi.org/10.1371/journal.pone.0329312 |
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