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

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.