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Document 0443
DOCN M9650443
TI The effect of human immunodeficiency virus infection on birthweight, and
infant and child mortality in urban Malawi.
DT 9605
AU Taha TE; Dallabetta GA; Canner JK; Chiphangwi JD; Liomba G; Hoover DR;
Miotti PG; Department of Epidemiology, Johns Hopkins University School
of; Hygiene and Public Health, Baltimore, MD 21205, USA.
SO Int J Epidemiol. 1995 Oct;24(5):1022-9. Unique Identifier : AIDSLINE
MED/96128733
AB BACKGROUND. Low birthweight, prematurity and intra-uterine growth
retardation (IUGR) are major determinants of child survival. Therefore,
it is important to assess excess mortality due to human immunodeficiency
virus (HIV) infection in populations where low birthweight is common.
METHODS. A prospective study was conducted on 1385 children born to
seropositive and seronegative women in urban Malawi. Children were
regularly examined and tested for HIV. RESULTS. The mortality rate of
children of HIV seropositive mothers was substantially higher (223/1000
at 12 months, 317/1000 at 24 months and 360/1000 at 30 months) than that
of children of seronegative mothers (68/1000 at 12 months, 106/1000 at
24 months and 118/1000 at 30 months). The incidence of prematurity and
IUGR was also higher in infants of HIV seropositive mothers than in
infants of seronegative mothers (12.7% versus 3.8%, P < 0.001 for
premature and 7.7% versus 4.4%, P = 0.02 for IUGR infants). The
mother-to-infant HIV-1 transmission rate was 35.1%. After 12 months of
age, HIV infected children showed the highest mortality; however,
uninfected children of HIV seropositive and children of HIV seronegative
mothers had similar mortality. The mean birthweight of HIV infected and
uninfected children was not significantly different. In HIV infected
children the most frequent causes of death were diarrhoea, pneumonia and
failure to thrive. Less common risk factors for child mortality included
active maternal syphilis and cervicitis/vaginitis. CONCLUSION. The
substantial difference in survival among children of HIV infected and
uninfected mothers suggests that mortality could be reduced if HIV
infection were not a risk factor. To decrease childhood mortality, a
combination of interventions such as treatment of sexually transmitted
infections during pregnancy and measures to reduce mother-to-infant
transmission should be adopted.
DE Birth Weight/*PHYSIOLOGY Case-Control Studies Cause of Death Disease
Transmission, Vertical/STATISTICS & NUMER DATA Female Fetal Growth
Retardation/EPIDEMIOLOGY/PHYSIOPATHOLOGY Human HIV
Seropositivity/EPIDEMIOLOGY/*MORTALITY/PHYSIOPATHOLOGY *HIV-1 *Infant
Mortality Infant, Low Birth Weight Infant, Newborn Infant, Premature
Malawi/EPIDEMIOLOGY Multivariate Analysis Pregnancy *Pregnancy
Complications, Infectious Prospective Studies Risk Factors Sexually
Transmitted Diseases/TRANSMISSION Support, U.S. Gov't, P.H.S. Survival
Analysis JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).