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

doi:10.1055/s-0030-1248937

American Journal of Perinatology, Table of Contents

Am J Perinatol 2010; 27(7): 517-523
DOI: 10.1055/s-0030-1248937

Predictors of Fetal Growth in Maternal HIV Disease

Sara N. Iqbal¹ , Jan Kriebs¹ , Christopher Harman¹ , Lindsay Alger¹ , Jerome Kopelman¹ , Ozhan Turan¹ , Sadettin Gungor¹ , Andrew Malinow¹ , Ahmet Alexander Baschat¹

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland, Baltimore, Maryland

Abstract

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 r ² = 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.

KEYWORDS

Fetal growth restriction - CD4 lymphocyte count - pregnancy - HIV

Full Text

References

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Ahmet Alexander BaschatM.D.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland, Baltimore

22 South Greene Street, Room N6E12, Baltimore, MD 21201-1703

Email: abaschat@umm.edu