Submission
| Title: | Neonatal Outcomes of Children who are HIV Exposed and Uninfected Compared with HIV Unexposed in Western Kenya |
| Presenter: | Mary Ann Etling |
| Institution: | Indiana University School of Medicine Richard M. Fairbanks School of Public Health |
| Authors: | Mary Ann Etling1,2, Eren Oyungu3,4, Ziyi Yang1, Emily Abuonji3, Carolyne Jerop3, Roselyne Ombitsa3, Cleophas Cherop3, Wanzhu Tu1, Megan S. McHenry1,3
1 Indiana University School of Medicine, Indianapolis, Indiana. |
Abstract
| Background/Significance/Rationale: | Nearly 16 million children are born to mothers with HIV globally and emerging literature suggests that those who are HIV-exposed and uninfected (HEU) are at an increased risk for adverse neonatal outcomes compared to their HIV unexposed, uninfected (HUU) peers. This study is among the first to further investigate whether maternal HIV exposure is associated with newborn unit (NBU) admission in Kenya. |
| Methods: | This is an interim analysis of a longitudinal cohort study of infants born to women living with HIV who are maternally age-matched to those born unexposed to HIV in western Kenya within the Academic Model for Providing Access to Healthcare (AMPATH) Partnership. Both maternal and infant characteristics were prospectively collected, and infants were followed for the first 28 days of life. Multivariable logistic regression was used to determine the associations between HIV exposure and NBU, adjusting for birthweight. |
| Results/Findings: | A total of 511 infants and their mothers were included for analysis, including 253 infants who are HEU and 258 unexposed infants. Eleven infants died prior to 28 days of life (n=7 HIV-exposed, n=4 HIV-unexposed; p=0.521). Maternal anemia and other maternal chronic disease (non-HIV) were significantly higher in the HEU cohort (24.5% vs. 8.1%, p<0.001; 4.0% vs 8.5%, p=0.047). Infants who are HEU had a significantly higher rate of NBU admission compared to HUU peers (13.0% vs. 2.7%, p<0.001), as well as higher rates of low birthweight (<2500 g), preterm birth (<37 weeks gestation), supportive care in 24 hours, and respiratory distress (21.3% vs. 10.9%, p=0.002; 23.7% vs. 13.2%, p<0.001; 10.3% vs. 3.9%, p<0.001; 6.7% vs. 1.2%, p=0.003.) When adjusting for birth weight, odds of NBU admission remained higher for infants who were HEU (aOR=4.55, 95% CI 2.06-11.5, p<0.001). |
| Conclusions/Discussion: | Infants who are HEU had increased odds of NBU admission, even after adjusting for birth weight. They also have higher rates of preterm birth, NBU admission, low birthweight, supportive care in 24 hours, and respiratory distress compared to unexposed infants. |
| Translational/Human Health Impact: | Close follow-up and medical management of pregnant women living with HIV is critical for improving care for infants exposed to HIV in Kenya. |
