Association of previous severe low birth weight with adverse perinatal outcomes in a subsequent pregnancy among HIV-prevalent urban African women.

Abstract

To evaluate the association between severity of prior low birth weight (LBW) delivery and adverse perinatal outcomes in the subsequent delivery among an HIV-prevalent urban African population. A retrospective cohort study was conducted among 41109 women who had undergone two deliveries in Lusaka, Zambia, between February 1, 2006, and May 31, 2013. The relationship between prior LBW delivery (<2500g) and a composite measure of adverse perinatal outcome in the second pregnancy was assessed using multivariate logistic regression. Women with prior LBW delivery (n=4259) had an increased risk of LBW in the second delivery versus those without prior LBW delivery (n=37642). Such risk correlated with the severity of first delivery LBW. The adjusted odds ratio (AOR) was 2.89 (95% confidence interval [CI] 2.05-4.09) for a birth weight of 1000-1499g, 3.05 (95% CI 2.42-3.86) for a birth weight of 1500-1999g, and 2.02 (95% CI 1.81-2.27) for a birth weight of 2000-2499g. Previous LBW delivery also increased the risk of adverse perinatal outcome, with an AOR of 1.4 (95% CI 1.2-1.7). Severe prior LBW delivery conferred substantial risk for adverse perinatal outcomes in a subsequent pregnancy.