Ayesha Sania1, Emily R Smith2, Karim Manji3, Christopher Duggan4, Honorati Masanja5, Rodrick Kisenge3, Gernard Msamanga6, Willy Urassa7, Wafaie Fawzi8. 1. ICAP, Columbia University, Mailman School of Public Health, New York, NY. 2. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA. Electronic address: ers231@mail.harvard.edu. 3. Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 4. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. 5. Ifakara Health Institute, Dar es Salaam, Tanzania. 6. Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 7. Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 8. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Abstract
OBJECTIVES: To evaluate the risk of newborn and infant mortality associated with preterm, small for gestational age (SGA), and low birth weight (LBW) stratified by maternal HIV status and the location of birth. STUDY DESIGN: We created a prospective cohort by pooling 5 individually randomized trials. We used Cox proportional hazard models to estimate the risk of mortality for SGA defined using the recently published Intergrowth standard, preterm, LBW, and gestational age and size for gestational age categories (preterm- appropriate for gestational age [AGA], term-SGA, and preterm-SGA). Effect modification by maternal HIV status and place of residence was assessed using the likelihood ratio test. RESULTS: Of the 31 988 infants, 15.3% were preterm, 16.6% were SGA, and 7.3% were LBW. The proportion of preterm and SGA births was higher among the HIV-infected cohort than in the uninfected cohort. Compared with term-AGA groups, infants born both preterm and SGA had a greater risk of neonatal mortality (hazard ratio [HR] 5.43, 95% CI 2.01-14.63) than preterm-AGA infants (HR 2.40, 95% CI 1.89-3.05) and term-SGA infants (HR 2.56, 95% CI 1.96-3.34). Maternal HIV infection modified the risk of infant mortality associated with being born preterm or LBW, with a higher relative risk among those born to HIV-uninfected women. Rural residence significantly modified the risk of neonatal mortality associated with being LBW (P for interaction = .005). CONCLUSIONS: Preterm and SGA newborns had an increased risk of mortality during the first year of life. Interventions targeting these conditions, especially in HIV-exposed and rural populations, should be integrated into existing maternal and child health programs.
OBJECTIVES: To evaluate the risk of newborn and infant mortality associated with preterm, small for gestational age (SGA), and low birth weight (LBW) stratified by maternal HIV status and the location of birth. STUDY DESIGN: We created a prospective cohort by pooling 5 individually randomized trials. We used Cox proportional hazard models to estimate the risk of mortality for SGA defined using the recently published Intergrowth standard, preterm, LBW, and gestational age and size for gestational age categories (preterm- appropriate for gestational age [AGA], term-SGA, and preterm-SGA). Effect modification by maternal HIV status and place of residence was assessed using the likelihood ratio test. RESULTS: Of the 31 988 infants, 15.3% were preterm, 16.6% were SGA, and 7.3% were LBW. The proportion of preterm and SGA births was higher among the HIV-infected cohort than in the uninfected cohort. Compared with term-AGA groups, infants born both preterm and SGA had a greater risk of neonatal mortality (hazard ratio [HR] 5.43, 95% CI 2.01-14.63) than preterm-AGA infants (HR 2.40, 95% CI 1.89-3.05) and term-SGA infants (HR 2.56, 95% CI 1.96-3.34). Maternal HIV infection modified the risk of infant mortality associated with being born preterm or LBW, with a higher relative risk among those born to HIV-uninfectedwomen. Rural residence significantly modified the risk of neonatal mortality associated with being LBW (P for interaction = .005). CONCLUSIONS: Preterm and SGA newborns had an increased risk of mortality during the first year of life. Interventions targeting these conditions, especially in HIV-exposed and rural populations, should be integrated into existing maternal and child health programs.
Authors: Naoko Kozuki; Joanne Katz; Parul Christian; Anne C C Lee; Li Liu; Mariangela F Silveira; Fernando Barros; James M Tielsch; Christentze Schmiegelow; Ayesha Sania; Dominique Roberfroid; Richard Ndyomugyenyi; Luke C Mullany; Aroonsri Mongkolchati; Lieven Huybregts; Jean Humphrey; Wafaie Fawzi; Abdullah H Baqui; Linda Adair; Vanessa M Oddo; Robert E Black Journal: JAMA Pediatr Date: 2015-07-06 Impact factor: 16.193
Authors: Christine M McDonald; Karim P Manji; Rodrick Kisenge; Said Aboud; Donna Spiegelman; Wafaie W Fawzi; Christopher P Duggan Journal: J Nutr Date: 2015-07-22 Impact factor: 4.798
Authors: Jennifer Y Chen; Heather J Ribaudo; Sajini Souda; Natasha Parekh; Anthony Ogwu; Shahin Lockman; Kathleen Powis; Scott Dryden-Peterson; Tracy Creek; William Jimbo; Tebogo Madidimalo; Joseph Makhema; Max Essex; Roger L Shapiro Journal: J Infect Dis Date: 2012-10-12 Impact factor: 5.226
Authors: Wafaie W Fawzi; Gernard I Msamanga; Roland Kupka; Donna Spiegelman; Eduardo Villamor; Ferdinand Mugusi; Ruilan Wei; David Hunter Journal: Am J Clin Nutr Date: 2007-05 Impact factor: 7.045
Authors: Joanne Katz; Keith P West; Subarna K Khatry; Parul Christian; Steven C LeClerq; Elizabeth Kimbrough Pradhan; Sharada Ram Shrestha Journal: Bull World Health Organ Date: 2003-11-25 Impact factor: 9.408
Authors: Tony Antoniou; Brandon Zagorski; Erin M Macdonald; Ahmed M Bayoumi; Janet Raboud; Jason Brophy; Khatundi-Irene Masinde; Wangari E Tharao; Mark H Yudin; Ryan Ng; Mona R Loutfy; Richard H Glazier Journal: Int J STD AIDS Date: 2014-03-19 Impact factor: 1.359
Authors: Mary K Quinn; Emily R Smith; Paige L Williams; Willy Urassa; Joy Shi; Gernard Msamanga; Wafaie W Fawzi; Christopher R Sudfeld Journal: J Nutr Date: 2020-02-01 Impact factor: 4.798
Authors: Moses Mukosha; Patrick Kaonga; Kunda Mutesu Kapembwa; Patrick Musonda; Bellington Vwalika; Mwansa Ketty Lubeya; Choolwe Jacobs Journal: Pan Afr Med J Date: 2021-05-25
Authors: Yamini V Pusdekar; Archana B Patel; Kunal G Kurhe; Savita R Bhargav; Vanessa Thorsten; Ana Garces; Robert L Goldenberg; Shivaprasad S Goudar; Sarah Saleem; Fabian Esamai; Elwyn Chomba; Melissa Bauserman; Carl L Bose; Edward A Liechty; Nancy F Krebs; Richard J Derman; Waldemar A Carlo; Marion Koso-Thomas; Tracy L Nolen; Elizabeth M McClure; Patricia L Hibberd Journal: Reprod Health Date: 2020-12-17 Impact factor: 3.223
Authors: Chris A Rees; Rodrick Kisenge; Karim P Manji; Enju Liu; Wafaie W Fawzi; Christopher P Duggan Journal: Pediatr Infect Dis J Date: 2020-12 Impact factor: 3.806