Predictors of Fetal Growth in Maternal HIV Disease

被引：15

作者：

Iqbal, Sara N. ^{[1
]}

Kriebs, Jan ^{[1
]}

Harman, Christopher ^{[1
]}

Alger, Lindsay ^{[1
]}

Kopelman, Jerome ^{[1
]}

Turan, Ozhan ^{[1
]}

Gungor, Sadettin ^{[1
]}

Malinow, Andrew ^{[1
]}

Baschat, Ahmet Alexander ^{[1
]}

机构：

[1] Univ Maryland, Dept Obstet Gynecol & Reprod Sci, Baltimore, MD 21201 USA

来源：

AMERICAN JOURNAL OF PERINATOLOGY | 2010年 / 27卷 / 07期

关键词：

Fetal growth restriction; CD4 lymphocyte count; pregnancy; HIV; INFECTED PREGNANT-WOMEN; LOW-BIRTH-WEIGHT; INTRAUTERINE GROWTH; TRANSMISSION; COHORT;

D O I：

10.1055/s-0030-1248937

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

We sought to determine predictors of fetal growth restriction in maternal HIV disease. Pregnant HIV-positive women on antiretroviral therapy were monitored with serial viral load and CD4 counts. Individualized growth potential (GP) percentile was calculated for birth weight (BW). BW <10th GP percentile defined fetal growth restriction (FOR). Multiple medical and social factors, CD4 count, viral load, and antiretroviral therapy were tested for impact on fetal growth using chi-square and multiple regression analysis. Two hundred eleven women were studied CD4 count <200 in the first trimester was strongly associated with FOR (odds ratio 8.75, 95% confidence interval 2.88 to 26.52). Maternal age (p = 0.02) and smoking (p = 0.03) were independent cofactors for FGR (Nagelkerke r(2) = 0.33). No other factors demonstrated an independent effect. Severity of maternal HIV disease as indicated by the CD4 count, rather than placental exposure to viral load, predicts FGR. Smoking has an independent detrimental effect on fetal growth.

引用

页码：517 / 523

页数：7

共 10 条

[1] Impairment of fetal growth potential and neonatal encephalopathy [J].

Bukowski, R ;

Burgett, AD ;

Gei, A ;

Saade, GR ;

Hankins, GDV .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2003, 188 (04) :1011-1015

[2] MATERNAL HUMAN-IMMUNODEFICIENCY-VIRUS-1 INFECTION AND INTRAUTERINE GROWTH - A PROSPECTIVE COHORT STUDY IN BUTARE, RWANDA [J].

BULTERYS, M ;

CHAO, A ;

MUNYEMANA, S ;

KURAWIGE, JB ;

NAWROCKI, P ;

HABIMANA, P ;

KAGERUKA, M ;

MUKANTABANA, S ;

MBARUTSO, E ;

DUSHIMIMANA, A ;

SAAH, A .

PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1994, 13 (02) :94-100

[3]

Cooper ER, 2002, J ACQ IMMUN DEF SYND, V29, P484, DOI 10.1097/00126334-200204150-00009

[4] Human immunodeficiency virus infection is a risk factor for adverse perinatal outcome [J].

Ellis, J ;

Williams, H ;

Graves, W ;

Lindsay, MK .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2002, 186 (05) :903-906

[5] Customized growth curves [J].

Gardosi, J .

CLINICAL OBSTETRICS AND GYNECOLOGY, 1997, 40 (04) :715-722

[6] Customized fetal growth standards: Rationale and clinical application [J].

Gardosi, J .

SEMINARS IN PERINATOLOGY, 2004, 28 (01) :33-40

[7]

Goldstein P J, 2000, Infect Dis Obstet Gynecol, V8, P94, DOI 10.1155/S1064744900000089

[8] Risk factors for preterm birth, low birth weight, and intrauterine growth retardation in infants born to HIV-infected pregnant women receiving zidovudine [J].

Lambert, JS ;

Watts, DH ;

Mofenson, L ;

Stiehm, ER ;

Harris, DR ;

Bethel, J ;

Whitehouse, J ;

Jimenez, E ;

Gandia, J ;

Scott, G ;

O'Sullivan, MJ ;

Kovacs, A ;

Stek, A ;

Shearer, WT ;

Hammill, H ;

van Dyke, R ;

Maupin, R ;

Silio, M ;

Fowler, MG .

AIDS, 2000, 14 (10) :1389-1399

[9] Association of maternal HIV infection with low birth weight [J].

Markson, LE ;

Turner, BJ ;

Houchens, R ;

Silverman, NS ;

Cosler, L ;

Takyi, BK .

JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY, 1996, 13 (03) :227-234

[10] Obstetric and newborn outcomes in a cohort of HIV-infected pregnant women: A report of the women and infants transmission study [J].

Stratton, P ;

Tuomala, RE ;

Abboud, R ;

Rodriguez, E ;

Rich, K ;

Pitt, J ;

Diaz, C ;

Hammill, H ;

Minkoff, H .

JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY, 1999, 20 (02) :179-186

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