The Association Between HIV/AIDS During Pregnancy and Fetal Growth Parameters in Florida: A Population Based Study
Hamisu M. Salihu, Kara M. Stanley, Euna M. August, Hanna Weldeselasse, Alfred K. Mbah and Valerie E. Whiteman
Affiliation: University of South Florida, College of Public Health, Department of Epidemiology and Biostatistics, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA.
Keywords: Adverse fetal outcomes, HIV/AIDS in pregnancy, low birth weight, preterm birth, racial disparities, VLBW, VPTB, SGA, AHCA, ICD-9 codes.
In this population-based retrospective study, we sought to investigate the association between HIV/AIDS
during pregnancy and adverse birth outcomes, including low birth weight (LBW), very low birth weight (VLBW),
preterm birth (PTB), very preterm birth (VPTB), and small for gestational age (SGA), among women in Florida by sociodemographic
variables. Using data from Florida’s maternally linked birth cohort files, we examined singleton live births
in the state during 1998 to 2007 (N = 1,698,107). The study population was categorized based on the maternal HIV/AIDS
status. Poisson regression models were used to generate adjusted rate ratios (ARR) to estimate the association between
HIV/AIDS status and fetal growth parameters. The main outcome measures were fetal growth parameters, including
LBW, VLBW, PTB, VPTB, and SGA. As compared to HIV/AIDS-negative women, mothers with HIV/AIDS had
elevated risks for LBW (ARR = 1.40; 95% CI = 1.30-1.50), VLBW (ARR = 1.25; 95% CI = 1.04-1.51), SGA (ARR =
1.26; 95% CI = 1.17-1.35), PTB (ARR = 1.23; 95% CI = 1.03-1.47), and VPTB (ARR = 1.27; 95% CI = 1.20-1.36). Risk
estimates for LBW and SGA were highest among Hispanics mothers with HIV/AIDS, while white mothers with
HIV/AIDS had the highest risk levels for VLBW and PTB, compared to their HIV/AIDS negative counterparts. Our
findings show that women with HIV/AIDS have elevated risks for inhibited fetal growth and shortened gestation with
important racial/ethnic variation. This is the first known population-based study that reveals racial/ethnic differences in
HIV/AIDS-related fetal growth morbidity outcomes.
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