Maternal HIV/AIDS status and neurological outcomes in neonates: a population-based study.
ABSTRACT This study sought to examine the association between maternal HIV/AIDS infection and neonatal neurologic conditions in the state of Florida. We analyzed all births in the state of Florida from 1998 to 2007 using hospital discharge data linked to birth certificate records. The main outcomes of interest included selected neonatal neurologic complications, namely: fetal distress, cephalohematoma, intracranial hemorrhage, seizure, feeding difficulties, and other central nervous system complications. The sample size for this study was 1,645,515 records. All forms of substance abuse as well as cesarean section deliveries were more frequent in mothers with HIV/AIDS. Infants born to HIV-infected mothers showed higher proportions of feeding difficulties and seizures whereas HIV-negative mothers had a greater proportion of cases of fetal distress and cephalohematoma. Seizures and feeding difficulties are common among infants born to HIV/AIDS infected mothers. This population-based retrospective cohort study provides further understanding of the association between maternal HIV/AIDS status and neonatal neurological outcomes.
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ABSTRACT: BACKGROUND: Both intra-uterine exposure to maternal drugs and HIV are known to adversely affect the developing central nervous system. AIMS: (1) To describe the quality of GMs in infants who were intra-uterinely exposed to maternal opiate abuse and HIV; and (2) to analyze to what extent (a) perinatal events, (b) status of HIV-infection, and (c) the quality of GMs are associated with the neurodevelopmental outcome at 2 to 3years of age. PATIENTS AND METHOD: Seventy-seven children intra-uterinely exposed to both maternal opiate abuse and HIV in utero (41 boys and 36 girls; 39 born preterm) were videoed twice: first during the first 2months after term (writhing GMs) and again at 3-5months (fidgety GMs). Neurodevelopmental outcome was assessed at 2-3years of age. RESULTS: Thirty-eight infants showed abnormal writhing GMs; 25 infants had abnormal or absent fidgety movements; 22 children had an adverse neurodevelopmental outcome. The association between GM trajectories and outcome revealed a Cramer-V=0.75 (p<0.001). Those infants with active HIV-infection (n=10) did not differ from the 67 infants who were HIV-exposed but uninfected with respect to their GM quality or outcome. CONCLUSIONS: Serial assessment of GMs in infants who were intra-uterinely exposed to maternal opiates and to HIV can be utilized for early identification of infants at a higher risk for later deficits and needing early intervention.Early human development 03/2013; · 2.12 Impact Factor
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ABSTRACT: To examine the associations between maternal hepatitis B (HBV) and hepatitis C (HCV) infection status and selected infant neurological outcomes diagnosed at birth, we conducted a population-based, retrospective cohort study on singleton live births in Florida from 1998 to 2009. Primary exposures included maternal HBV and HCV monoinfection. The neurological outcomes included brachial plexus injury, cephalhematoma, foetal distress, feeding difficulties, intraventricular h aemorrhage and neonatal seizures. Multivariable logistic regression models were used to generate odds ratios (OR) and 95% confidence intervals (CI) that were adjusted for socio-demographic characteristics, risky behaviours, pregnancy complications and pre-existing medical conditions, and timing of delivery. The risk of an adverse neurological outcome was higher in infants born to mothers with hepatitis viral infection (7.2% for HCV, 5.0% for HBV), compared with infants of hepatitis virus-free mothers (4.2%). After adjusting for potential confounders, women with HBV were twice as likely to have infants who suffered from brachial plexus injury (OR = 2.04, 95% CI = 1.15-3.60), while those with HCV had an elevated odds of having an infant with feeding difficulties (OR: 1.32, 95% CI = 1.06-1.64) and a borderline increased likelihood for neonatal seizures (OR = 1.74, 95% CI = 0.98-3.10). Additionally, HCV+ mothers had a 22% increased odds of having an infant with some type of adverse neurological outcome (OR: 1.22, 95% CI = 1.03-1.44). Our findings add to current understanding of the association between maternal HBV/HCV infections and infant neurological outcomes. Further research evaluating the role of maternal HBV and HCV infections (including viraemia, treatment) on pregnancy outcomes is warranted.Journal of Viral Hepatitis 03/2014; · 3.08 Impact Factor