Predictors of fetal growth in maternal HIV disease

Sara N. Iqbal, Jan Kriebs, Christopher Harman, Lindsay Alger, Jerome Kopelman, Ozhan Turan, Sadettin Gungor, Andrew Malinow, Ahmet Alexander Baschat

Research output: Contribution to journalArticlepeer-review

Abstract

We sought to determine predictors of fetal growth restriction in maternal HIV disease. Pregnant HIV-positive women on antiretroviral therapy were monitored with serial viral load and CD4 counts. Individualized growth potential (GP) percentile was calculated for birth weight (BW). BW <10th GP percentile defined fetal growth restriction (FGR). Multiple medical and social factors, CD4 count, viral load, and antiretroviral therapy were tested for impact on fetal growth using chi-square and multiple regression analysis. Two hundred eleven women were studied. CD4 count <200 in the first trimester was strongly associated with FGR (odds ratio 8.75, 95% confidence interval 2.88 to 26.52). Maternal age (p=0.02) and smoking (p=0.03) were independent cofactors for FGR (Nagelkerke r2=0.33). No other factors demonstrated an independent effect. Severity of maternal HIV disease as indicated by the CD4 count, rather than placental exposure to viral load, predicts FGR. Smoking has an independent detrimental effect on fetal growth.

Original languageEnglish (US)
Pages (from-to)517-523
Number of pages7
JournalAmerican journal of perinatology
Volume27
Issue number7
DOIs
StatePublished - Jul 29 2010
Externally publishedYes

Keywords

  • CD4 lymphocyte count
  • Fetal growth restriction
  • HIV
  • pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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