Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1992 May;67(5):595–599. doi: 10.1136/adc.67.5.595

HIV-1 infection and perinatal mortality in Zimbabwe.

C G Aiken 1
PMCID: PMC1793718  PMID: 1599295

Abstract

As part of a survey of the causes of perinatal mortality at Mpilo Maternity Hospital, 220 neonatal deaths and the mothers of 221 stillbirths were tested for HIV-1 antibodies. The HIV positive rate in neonatal deaths was 23.6% (95% confidence interval (CI) 18.0 to 29.2%), significantly higher than 15.4% (95% CI 10.6 to 20.1%) in stillbirths. Perinatal deaths from congenital malformations, birth asphyxia, pregnancy induced hypertension, placental abruption, and oFther non-infectious causes had similar low HIV positive rates averaging 8.1% (95% CI 3.9 to 12.3%). Deaths from septicaemia had a significantly greater rate of 39.3% (95% CI 27.0 to 51.6%) and the highest rate of 72.2% (95% CI 51.5 to 92.9%) was found in deaths from congenital infection other than syphilis, indicating that maternal HIV infection predisposes to neonatal septicaemia and congenital infection. Unexplained stillbirths also had a significantly greater rate of 22.4% (95% CI 10.7 to 34.1%), presumably because some died from unrecognised infection. The rate in deaths from congenital syphilis was 17.4% (95% CI 9.6 to 25.2%), indicating a significant but weak association between these two sexually transmitted diseases in Bulawayo. The rate in deaths from hyaline membrane disease was not significantly greater at 15.0% (95% CI 6.0 to 24.0%). By predisposing to infection, maternal HIV infection was estimated to increase the stillbirth rate by 1.6 times and the neonatal mortality rate by 2.7 times. It predisposed equally to early and late onset neonatal septicaemia, but more to infection from streptococci and staphylococci than from Gram negative enterobacteria. HIV positive deaths from congenital infection had respiratory distress and usually intrauterine growth retardation, hepatosplenomegaly, and congenital pneumonia on lung histology.

Full text

PDF
598

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andiman W. A., Simpson B. J., Olson B., Dember L., Silva T. J., Miller G. Rate of transmission of human immunodeficiency virus type 1 infection from mother to child and short-term outcome of neonatal infection. Results of a prospective cohort study. Am J Dis Child. 1990 Jul;144(7):758–766. doi: 10.1001/archpedi.1990.02150310026020. [DOI] [PubMed] [Google Scholar]
  2. Blanche S., Rouzioux C., Moscato M. L., Veber F., Mayaux M. J., Jacomet C., Tricoire J., Deville A., Vial M., Firtion G. A prospective study of infants born to women seropositive for human immunodeficiency virus type 1. HIV Infection in Newborns French Collaborative Study Group. N Engl J Med. 1989 Jun 22;320(25):1643–1648. doi: 10.1056/NEJM198906223202502. [DOI] [PubMed] [Google Scholar]
  3. Borkowsky W., Krasinski K., Paul D., Holzman R., Moore T., Bebenroth D., Lawrence R., Chandwani S. Human immunodeficiency virus type 1 antigenemia in children. J Pediatr. 1989 Jun;114(6):940–945. doi: 10.1016/s0022-3476(89)80434-2. [DOI] [PubMed] [Google Scholar]
  4. Braddick M. R., Kreiss J. K., Embree J. B., Datta P., Ndinya-Achola J. O., Pamba H., Maitha G., Roberts P. L., Quinn T. C., Holmes K. K. Impact of maternal HIV infection on obstetrical and early neonatal outcome. AIDS. 1990 Oct;4(10):1001–1005. doi: 10.1097/00002030-199010000-00009. [DOI] [PubMed] [Google Scholar]
  5. Gloeb D. J., O'Sullivan M. J., Efantis J. Human immunodeficiency virus infection in women. I. The effects of human immunodeficiency virus on pregnancy. Am J Obstet Gynecol. 1988 Sep;159(3):756–761. doi: 10.1016/s0002-9378(88)80049-8. [DOI] [PubMed] [Google Scholar]
  6. Goedert J. J., Mendez H., Drummond J. E., Robert-Guroff M., Minkoff H. L., Holman S., Stevens R., Rubinstein A., Blattner W. A., Willoughby A. Mother-to-infant transmission of human immunodeficiency virus type 1: association with prematurity or low anti-gp120. Lancet. 1989 Dec 9;2(8676):1351–1354. doi: 10.1016/s0140-6736(89)91965-x. [DOI] [PubMed] [Google Scholar]
  7. Hira S. K., Kamanga J., Bhat G. J., Mwale C., Tembo G., Luo N., Perine P. L. Perinatal transmission of HIV-I in Zambia. BMJ. 1989 Nov 18;299(6710):1250–1252. doi: 10.1136/bmj.299.6710.1250. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Howard-Gardiner H., Roberts P. D., Dunn P. M. Congenital human immunodeficiency virus (HIV) infection in the Bahamas. Br J Obstet Gynaecol. 1989 Feb;96(2):140–143. doi: 10.1111/j.1471-0528.1989.tb01652.x. [DOI] [PubMed] [Google Scholar]
  9. Johnstone F. D., MacCallum L., Brettle R., Inglis J. M., Peutherer J. F. Does infection with HIV affect the outcome of pregnancy? Br Med J (Clin Res Ed) 1988 Feb 13;296(6620):467–467. doi: 10.1136/bmj.296.6620.467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lallemant M., Lallemant-Le-Coeur S., Cheynier D., Nzingoula S., Jourdain G., Sinet M., Dazza M. C., Blanche S., Griscelli C., Larouzé B. Mother-child transmission of HIV-1 and infant survival in Brazzaville, Congo. AIDS. 1989 Oct;3(10):643–646. doi: 10.1097/00002030-198910000-00004. [DOI] [PubMed] [Google Scholar]
  11. Lepage P., Dabis F., Hitimana D. G., Msellati P., Van Goethem C., Stevens A. M., Nsengumuremyi F., Bazubagira A., Serufilira A., De Clercq A. Perinatal transmission of HIV-1: lack of impact of maternal HIV infection on characteristics of livebirths and on neonatal mortality in Kigali, Rwanda. AIDS. 1991 Mar;5(3):295–300. [PubMed] [Google Scholar]
  12. Lepage P., Van de Perre P., Nsengumuremyi F., Van Goethem C., Bogaerts J., Hitimana D. G. Bacteraemia as predictor of HIV infection in African children. Acta Paediatr Scand. 1989 Sep;78(5):763–766. doi: 10.1111/j.1651-2227.1989.tb11140.x. [DOI] [PubMed] [Google Scholar]
  13. Mok J. Y., Hague R. A., Yap P. L., Hargreaves F. D., Inglis J. M., Whitelaw J. M., Steel C. M., Eden O. B., Rebus S., Peutherer J. F. Vertical transmission of HIV: a prospective study. Arch Dis Child. 1989 Aug;64(8):1140–1145. doi: 10.1136/adc.64.8.1140. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Rogers M. F., Ou C. Y., Rayfield M., Thomas P. A., Schoenbaum E. E., Abrams E., Krasinski K., Selwyn P. A., Moore J., Kaul A. Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers. New York City Collaborative Study of Maternal HIV Transmission and Montefiore Medical Center HIV Perinatal Transmission Study Group. N Engl J Med. 1989 Jun 22;320(25):1649–1654. doi: 10.1056/NEJM198906223202503. [DOI] [PubMed] [Google Scholar]
  15. Ryder R. W., Nsa W., Hassig S. E., Behets F., Rayfield M., Ekungola B., Nelson A. M., Mulenda U., Francis H., Mwandagalirwa K. Perinatal transmission of the human immunodeficiency virus type 1 to infants of seropositive women in Zaire. N Engl J Med. 1989 Jun 22;320(25):1637–1642. doi: 10.1056/NEJM198906223202501. [DOI] [PubMed] [Google Scholar]
  16. Scott G. B., Hutto C., Makuch R. W., Mastrucci M. T., O'Connor T., Mitchell C. D., Trapido E. J., Parks W. P. Survival in children with perinatally acquired human immunodeficiency virus type 1 infection. N Engl J Med. 1989 Dec 28;321(26):1791–1796. doi: 10.1056/NEJM198912283212604. [DOI] [PubMed] [Google Scholar]
  17. Selwyn P. A., Schoenbaum E. E., Davenny K., Robertson V. J., Feingold A. R., Shulman J. F., Mayers M. M., Klein R. S., Friedland G. H., Rogers M. F. Prospective study of human immunodeficiency virus infection and pregnancy outcomes in intravenous drug users. JAMA. 1989 Mar 3;261(9):1289–1294. [PubMed] [Google Scholar]
  18. Temmerman M., Plummer F. A., Mirza N. B., Ndinya-Achola J. O., Wamola I. A., Nagelkerke N., Brunham R. C., Piot P. Infection with HIV as a risk factor for adverse obstetrical outcome. AIDS. 1990 Nov;4(11):1087–1093. doi: 10.1097/00002030-199011000-00006. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES