Mayowa Tiam1, Sithembiso Velaphi1. 1. a Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
Abstract
BACKGROUND: Human immunodeficiency virus (HIV) remains a common cause of infection in pregnant women. The effect of HIV exposure on growth, morbidity and mortality in very low-birthweight infants (VLBWI) is under-reported. AIM: To determine anthropometry at birth, morbidity during hospital stay and mortality at hospital discharge of VLBWI stratified according to HIV-exposure in a tertiary public government hospital in Johannesburg, South Africa. METHODS: Retrospective descriptive study. Records of VLBWI were reviewed for maternal HIV status, infant characteristics, diagnosis and outcome to hospital discharge. Anthropometry, morbidity and mortality were compared according to HIV-exposure. RESULTS: Of 302 VLBWI,103 (34.1%)were HIV-exposed. Among the 103mothers, 38 (36.9%)were on combined anti-retroviral therapy (cART), 41 (39.8%) were on zidovudine (AZT) and 24 (23%) were not on either. More HIV-exposed VLBWI weighed v1000 g (41.2 vs 23.1%, Pv0.01). There were no differences in incidence or number of episodes of sepsis between HIV-exposed and -unexposed. More HIV-exposed VLBWI had severe intraventricular haemorrhage (IVH) (57.1 vs 11.4%, Pv0.01). The overall mortality rate was 27%, with HIV-exposed VLBWI having a mortality rate of 38.6% compared with 21% of the HIV-unexposed (Pv0.01). On multivariate analysis, the predictor of mortality was birthweight (Pv0.01). CONCLUSION: HIV-exposed VLBWI are more likely to have extremely low birthweights. Morbidity in VLBWI is not affected by HIV-exposure, except for severe IVH. Birthweight is a predictor of mortality in VLBWI, irrespective of maternal HIV status.
BACKGROUND:Human immunodeficiency virus (HIV) remains a common cause of infection in pregnant women. The effect of HIV exposure on growth, morbidity and mortality in very low-birthweight infants (VLBWI) is under-reported. AIM: To determine anthropometry at birth, morbidity during hospital stay and mortality at hospital discharge of VLBWI stratified according to HIV-exposure in a tertiary public government hospital in Johannesburg, South Africa. METHODS: Retrospective descriptive study. Records of VLBWI were reviewed for maternal HIV status, infant characteristics, diagnosis and outcome to hospital discharge. Anthropometry, morbidity and mortality were compared according to HIV-exposure. RESULTS: Of 302 VLBWI,103 (34.1%)were HIV-exposed. Among the 103mothers, 38 (36.9%)were on combined anti-retroviral therapy (cART), 41 (39.8%) were on zidovudine (AZT) and 24 (23%) were not on either. More HIV-exposed VLBWI weighed v1000 g (41.2 vs 23.1%, Pv0.01). There were no differences in incidence or number of episodes of sepsis between HIV-exposed and -unexposed. More HIV-exposed VLBWI had severe intraventricular haemorrhage (IVH) (57.1 vs 11.4%, Pv0.01). The overall mortality rate was 27%, with HIV-exposed VLBWI having a mortality rate of 38.6% compared with 21% of the HIV-unexposed (Pv0.01). On multivariate analysis, the predictor of mortality was birthweight (Pv0.01). CONCLUSION:HIV-exposed VLBWI are more likely to have extremely low birthweights. Morbidity in VLBWI is not affected by HIV-exposure, except for severe IVH. Birthweight is a predictor of mortality in VLBWI, irrespective of maternal HIV status.
Entities:
Keywords:
Human immunodeficiency virus; Intraventricular haemorrhage; Mortality; Necrotising enterocolitis; Nosocomial infections; Very low birthweight infants
Authors: R MacLeod; J N Paulson; N Okalany; F Okello; L Acom; J Ikiror; F M Cowan; C J Tann; L E Dyet; C F Hagmann; K Burgoine Journal: BMC Pediatr Date: 2021-01-06 Impact factor: 2.125