Preterm birth add fetal growth restriction in hiv-infected Brazilian pregnant women / Nascimento pré-termo e restrição de crescimento fetal em gestantes brasileiras infectadas pelo HIV
DOS REIS, Helena Lucia Barroso; ARAUJO, Karina da Silva; RIBEIRO, Lilian Paula; DA ROCHA, Daniel Ribeiro; ROSATO, Drielli Petri; PASSOS, Mauro Romero Leal; MERÇON DE VARGAS, Paulo Roberto.
Rev. Inst. Med. Trop. Säo Paulo
; 57(2): 111-120, Mar-Apr/2015. tab, graf
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en Inglés
| LILACS | ID: lil-744728
Introduction:
Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR).Objective:
To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients andMethods:
Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles.Results:
PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were PTB 5.9 versus 27.5%, LBW 14.7% versus 25.0%, SGA BW 17.6% versus 15.0%, BL 6.0% versus 30.0%, HC 9.0% versus 17.9%, and AC 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent.Conclusions:
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