Determinants of low birth weight among newborns to HIV-infected mothers not eligible for antiretroviral treatment in Africa

Background. - Low birth weight (LBW) increases the risk of infant death, but little is known about its rate and determinants among babies born to HIV-infected mothers in sub-Saharan Africa. Methods. - This study was conducted in South Africa, Burkina Faso, Uganda and Zambia, during the recruitment process of the PROMISE-PEP (ANRS 12174) clinical trial. The study sample included 1196 subjects screened between August 2009 and December 2011, respectively 254 in South Africa, 221 in Burkina Faso, 197 in Uganda and 524 in Zambia, all ineligible for antiretroviral therapy. Data were collected during ANRS12174 clinical trial antenatal and postnatal screening visits, and during an inclusion visit for completion of an electronic case report form (eCRF). Results. - The mean (+/- SD) age of mothers was 27 +/- 5 years and their mean CD4 count was 576 +/- 195 cells/mu L. Most mothers lived in a couple (78.7%), had no employment (72.3%) and had a good level of education (74% had gone to school). Male newborns predominated (51.7%). The mean birth weight was 3043 g +/- 435 g, and 7.8% ([95% CI: 6.3%-9.3%]) of newborns weighed less than 2500 g. In univariate analyses, being married or cohabiting, body mass index, WHO HIV disease stage II, female newborn and low gestational age were associated with risk of LBW. In multivariate regression model, low gestational age (aOR = 3.74, P < 0.0001) and female newborn (aOR = 1.63, P = 0.04) were significantly associated with LBW. Conclusion. - The risk factors for LBW found in HIV-infected women ineligible for antiretroviral therapy were the same as in the general population. There was no evidence of additional risk factors associated with HIV infection. (C) 2013 Elsevier Masson SAS. All rights reserved.