Abstract
BackgroundTo assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women.MethodsSeveral English and Chinese databases were searched (updated to May 2015) to find the studies reporting infant outcomes associated with exposure to maternal HIV infection during pregnancy. Relevant articles were manually selected based on several inclusion and exclusion criteria.ResultsFifty-two cohort studies including 15,538 (for LBW) and 200,896 (for PTD) HIV infected women met the inclusion criteria. There was significant heterogeneity among studies for maternal HIV infection associated with LBW/PTD (I2 = 71.7 %, P < 0.05, and I2 = 51.8 %, P < 0.05 for LBW and PTD, respectively). The meta-analysis demonstrated that the maternal HIV infection was significantly associated with both LBW (pooled odds ratio (OR): 1.73, 95 % confidence interval (CI): 1.64, 1.82, P < 0.001) and PTD (pooled OR: 1.56, 95 % CI: 1.49, 1.63, P < 0.001). No significant difference in the relationship between maternal HIV infection and adverse pregnancy outcomes was detected among the groups of different study periods. HIV infected women were at slightly higher risk of LBW in developing countries compared with women in developed countries (OR: 2.12 (95 % CI: 1.81, 2.48) vs. 1.75 (95 % CI: 1.44, 2.12)). Antiretroviral drugs usage did not significantly change the associations of maternal HIV exposure with LBW and PTD.ConclusionsHIV infected women were at higher risk of having a low birth weight infant or a preterm delivery infant compared with uninfected women. Such associations did not change significantly over time or were not significantly affected by the usage of antiretroviral drugs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0684-z) contains supplementary material, which is available to authorized users.
Highlights
To assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women
Impact of maternal HIV infection on LBW and preterm delivery (PTD) There was significant heterogeneity among studies for maternal HIV infection associated with LBW/PTD (I2 = 71.7 %, P < 0.05, and I2 = 51.8 %, P < 0.05 for LBW and PTD, respectively) suggesting that the summary measures need to be interpreted with caution
Brocklehurst et al [5] reported that the increasing risks of LBW and PTD were associated with maternal HIV infection
Summary
To assess the association between maternal human immunodeficiency virus (HIV) infection and low birth weight (LBW)/prematurity (PTD), we conducted a meta-analysis of cohort studies of HIV infected and uninfected women. Brocklehurst et al [5] summarized the study results published between 1983 and 1996 They found the association of maternal HIV infection with adverse pregnancy outcomes such as LBW and PTD, but failed to assess the effect of antiretroviral drugs on it. There have been many new studies on the association between maternal HIV infection and adverse pregnancy outcomes reported in the past 20 years. For this reason, we conducted a meta-analysis to provide an update on the relationship between maternal HIV infection and LBW/PTD. There has been a rapid progress of medication and heath care for HIV infected women, and we assessed the influence of such a progress on the relationship
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