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).