236609 An assessment of the role of prenatal care on birth outcomes of HIV exposed infants born in Louisiana from 2005 to 2008

Sunday, October 30, 2011

Tamala Gondwe, MPH, CHES , Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Background:Thus far, research of HIV exposed infants has focused on incidence of perinatal HIV infection. There is a lack of published research on birth outcomes of HIV exposed infants in Louisiana. This study used available surveillance data to assess whether adverse birth outcomes in infants born to HIV infected women are associated with prenatal care factors. Methods: Using data from Louisiana's electronic HIV databases, cross tabulations and bivariate logistic regression estimated crude and unadjusted odds ratios between the exposure, prenatal care (PNC), and outcomes, low birth weight (LBW) and preterm birth (PTB), as well as other predictor variables to assess for confounding. Multivariable logistic regression was used to estimate adjusted odds ratios. Results: Of the 655 infants in this cohort, 23.0% were LBW and 31.5% were PTB. 41.4% of women had early PNC and 6.7% of women had no PNC. Women who had no PNC were more likely to have a PTB infant compared to women who had early PNC (aOR 2.62, 95% CI 1.08-6.40). Women who had no PNC were also more likely to have an LBW infant compared to women with early PNC, however this association was not significant (aOR 2.06, 95% CI 0.86-4.89). Other maternal factors such as substance use during pregnancy and non-elective caesarean delivery method were also associated with an increased likelihood of PTB and LBW. Conclusion: HIV infected pregnant women who have no PNC have a significantly increased risk of adverse birth outcomes, particularly PTB, compared to those who have early onset of PNC.

Learning Areas:
Public health or related research

Learning Objectives:
1. Assess whether prenatal care factors affected adverse birth outcomes, specifically low birth weight (LBW) and preterm birth (PTB), in a cohort of infants born to HIV infected women in Louisiana from 2005 to 2008. 2. Identify other maternal factors that contribute to adverse birth outcomes in infants born to HIV infected women.

Keywords: Birth Outcomes, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this analysis for my MPH thesis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.