Table 5.
Multivariate analysis of risk factors associated with neonatal adverse effects
| Risk Factors | Birth weight | Relative Risk | Logistic Regression | Gestational age at birth | Relative Risk | Logistic Regression | Anemia | Relative Risk | Logistic Regression | Hepatic alterations | Relative Risk | Logistic Regression | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| <2500 g | >=2500 g | <37 weeks | >=37 weeks | Yes | No | Yes | No | |||||||||||||||||
| n | % | n | % | RR CI 95% | RR CI 95% | n | % | n | % | RR CI 95% | RR CI 95% | n | % | n | % | RR CI 95% | RR CI 95% | n | % | n | % | RR CI 95% | RR CI 95% | |
| Maternal age | ||||||||||||||||||||||||
| <=28 yrs | 84 | 47.2 | 332 | 54.1 | 1 | 102 | 54.0 | 312 | 52.2 | 1 | 104 | 56.2 | 270 | 50.2 | 1 | 63 | 49.2 | 104 | 46.2 | 1 | ||||
| >28 yrs | 94 | 52.8 | 282 | 45.9 | 1.24 (0.92–1.66) | 87 | 46.0 | 286 | 47.8 | 0.95 (0.71–1.26) | 81 | 43.8 | 268 | 49.8 | 0.84 (0.62–1.12) | 65 | 50.8 | 121 | 53.8 | 0.93 (0.66–1.31) | ||||
| Hypertension | ||||||||||||||||||||||||
| No | 157 | 88.7 | 583 | 95.6 | 1 | 175 | 93.1 | 562 | 94.6 | 1 | 181 | 97.8 | 499 | 93.4 | 1 | 120 | 94.5 | 212 | 94.6 | 1 | ||||
| Yes | 20 | 11.3 | 27 | 4.4 | 2.01 (1.26–3.20) | 13 | 6.9 | 32 | 5.4 | 1.22 (0.69–2.14) | 4 | 2.2 | 35 | 6.6 | 0.39 (0.14–1.04) | 7 | 5.5 | 12 | 5.4 | 1.02 (0.48–2.18) | ||||
| No information | 1 | 4 | 1 | 4 | 4 | 1 | 1 | |||||||||||||||||
| Diabetes during pregnancy | ||||||||||||||||||||||||
| No | 160 | 94.7 | 523 | 93.4 | 1 | 168 | 96.0 | 511 | 93.1 | 1 | 160 | 94.7 | 469 | 93.2 | 1 | 106 | 93.8 | 212 | 95.1 | 1 | ||||
| Yes | 9 | 5.3 | 37 | 6.6 | 0.84 (0.43–1.64) | 7 | 4.0 | 38 | 6.9 | 0.63 (0.30–1.34) | 9 | 5.3 | 34 | 6.8 | 0.82 (0.42–1.61) | 7 | 6.2 | 11 | 4.9 | 1.17 (0.54–2.51) | ||||
| No information | 9 | 54 | 14 | 49 | 16 | 35 | 15 | 2 | ||||||||||||||||
| Coinfection during pregnancy | ||||||||||||||||||||||||
| No | 19 | 10.7 | 96 | 15.8 | 1 | 24 | 12.8 | 91 | 15.3 | 1 | 26 | 14.1 | 79 | 14.8 | 1 | 22 | 17.3 | 31 | 13.9 | 1 | ||||
| Yes | 158 | 89.3 | 513 | 84.2 | 1.42 (0.89–2.29) | 163 | 87.2 | 503 | 84.7 | 1.17 (0.76–1.80) | 159 | 85.9 | 454 | 85.2 | 1.05 (0.69–1.59) | 105 | 82.7 | 192 | 86.1 | 0.86 (0.54–1.35) | ||||
| No information | 1 | 5 | 2 | 4 | 0 | 5 | 1 | 2 | ||||||||||||||||
| Smoking | ||||||||||||||||||||||||
| No | 88 | 77.2 | 362 | 87.7 | 1 | 104 | 85.2 | 341 | 85.3 | 1 | 115 | 90.6 | 288 | 83.2 | 1 | 70 | 83.3 | 61 | 69.3 | 1 | ||||
| Yes | 26 | 22.8 | 51 | 12.3 | 1.73 (1.12–2.67) | 18 | 14.8 | 59 | 14.8 | 1 (0.57–1.65) | 12 | 9.4 | 58 | 16.8 | 0.6 (0.33–1.09) | 14 | 16.7 | 27 | 30.7 | 0.64 (0.36–1.13) | ||||
| No information | 64 | 201 | 67 | 198 | 58 | 192 | 44 | 137 | ||||||||||||||||
| Substance abuse | ||||||||||||||||||||||||
| No | 95 | 78.5 | 381 | 87.4 | 1 | 111 | 86.0 | 360 | 85.1 | 1 | 121 | 90.3 | 304 | 82.8 | 1 | 75 | 80.6 | 66 | 61.7 | 1 | 1 | |||
| Yes | 26 | 21.5 | 55 | 12.6 | 1.61 (1.04–2.48) | 18 | 14.0 | 63 | 14.9 | 0.94 (0.57–1.55) | 13 | 9.7 | 63 | 17.2 | 0.6 (0.34–1.07) | 18 | 19.4 | 41 | 38.3 | 0.5 (0.34–0.96) | 0.47 (0.27–0.83) | |||
| No information | 57 | 178 | 60 | 175 | 51 | 171 | 35 | 118 | ||||||||||||||||
| Alcoholism | ||||||||||||||||||||||||
| No | 98 | 92.5 | 388 | 94.9 | 1 | 113 | 95.8 | 368 | 93.9 | 1 | 123 | 96.9 | 312 | 92.9 | 1 | 79 | 95.2 | 69 | 81.2 | 1 | ||||
| Yes | 8 | 7.5 | 21 | 5.1 | 1.37 (0.67–2.81) | 5 | 4.2 | 24 | 6.1 | 0.73 (0.30–1.80) | 4 | 3.1 | 24 | 7.1 | 0.51 (0.19–1.37) | 4 | 4.8 | 16 | 18.8 | 0.38 (0.14–1.02) | ||||
| No information | 72 | 205 | 71 | 206 | 58 | 202 | 45 | 140 | ||||||||||||||||
| First CD4 (cells/mm3) | ||||||||||||||||||||||||
| <200 | 31 | 18.0 | 59 | 10.5 | 1 | 34 | 19.2 | 55 | 9.9 | 1 | 24 | 13.8 | 59 | 11.7 | 1 | 20 | 17.1 | 21 | 9.6 | 1 | ||||
| >=200 | 141 | 82.0 | 505 | 89.5 | 0.64 (0.43–0.94) | 143 | 80.8 | 499 | 90.1 | 0.58 (0.40–0.85) | 150 | 86.2 | 444 | 88.3 | 0.87 (0.57–1.34) | 97 | 82.9 | 198 | 90.4 | 0.67 (0.42–1.09) | ||||
| No information | 6 | 50 | 12 | 44 | 11 | 35 | 11 | 6 | ||||||||||||||||
| Peripartum CD4 (cells/mm3) | ||||||||||||||||||||||||
| <200 | 30 | 17.5 | 47 | 8.36 | 1 | 1 | 32 | 18.2 | 44 | 8.0 | 1 | 1 | 21 | 12.1 | 50 | 9.9 | 1 | 18 | 15.5 | 18 | 8.2 | 1 | ||
| >=200 | 141 | 82.5 | 515 | 91.6 | 0.55 (0.37–0.82) | 0.47 (0.29–0.77) | 144 | 81.8 | 508 | 92.0 | 0.53 (0.36–0.77) | 0.54 (0.37–0.79) | 152 | 87.9 | 453 | 90.1 | 0.85 (0.54–1.34) | 98 | 84.5 | 201 | 91.8 | 0.6 (0.40–1.08) | ||
| No information | 7 | 52 | 13 | 46 | 12 | 35 | 12 | 6 | ||||||||||||||||
| Peripartum viral load | ||||||||||||||||||||||||
| Undetectable (<50 copies/ml) | 92 | 54.8 | 343 | 60.4 | 1 | 99 | 56.3 | 336 | 60.5 | 1 | 106 | 60.9 | 302 | 59.7 | 1 | 58 | 49.2 | 168 | 76.0 | 1 | 1 | |||
| Detectable (>=50 copies/ml) | 76 | 45.2 | 225 | 39.6 | 1.19 (0.88–1.62) | 77 | 43.8 | 219 | 39.5 | 1.14 (0.85–1.54) | 68 | 39.1 | 204 | 40.3 | 0.96 (0.71–1.31) | 60 | 50.8 | 53 | 24.0 | 2.61 (1.44–2.97) | 2.37 (1.52–3.68) | |||
| No information | 10 | 46 | 13 | 43 | 11 | 32 | 10 | 4 | ||||||||||||||||
| CDC classification | ||||||||||||||||||||||||
| 1 | 47 | 26.9 | 177 | 30.4 | 1 | 44 | 24.2 | 180 | 31.5 | 1 | 49 | 27.4 | 158 | 30.4 | 1 | 40 | 32.8 | 63 | 28.1 | 1 | ||||
| 2 | 84 | 48.0 | 304 | 52.1 | 1.03 (0.72–1.48) | 87 | 47.8 | 298 | 52.2 | 1.15 (0.80–1.65) | 91 | 50.8 | 266 | 51.3 | 1.08 (0.76–1.52) | 54 | 44.3 | 114 | 50.9 | 0.83 (0.55–1.25) | ||||
| 3 | 44 | 25.1 | 102 | 17.5 | 1.44 (0.95–2.17) | 51 | 28.0 | 93 | 16.3 | 1.8 (1.20–2.70) | 39 | 21.8 | 95 | 18.3 | 1.23 (0.81–1.87) | 28 | 23.0 | 47 | 21.0 | 0.96 (0.59–1.56) | ||||
| No information | 3 | 31 | 7 | 27 | 6 | 19 | 6 | 1 | ||||||||||||||||
| Start of ART use | ||||||||||||||||||||||||
| Before pregnancy | 41 | 23.6 | 102 | 17.1 | 1 | 42 | 22.7 | 101 | 17.4 | 1 | 32 | 17.6 | 101 | 19.2 | 1 | 23 | 18.7 | 76 | 34.1 | 1 | 1 | |||
| During pregnancy | 133 | 76.4 | 495 | 82.9 | 0.74 (0.52–1.05) | 143 | 77.3 | 480 | 82.6 | 0.78 (0.55–1.10) | 150 | 82.4 | 424 | 80.8 | 1.09 (0.74–1.59) | 100 | 81.3 | 147 | 65.9 | 1.74 (1.11–2.74) | 1.5 (0.71–3.18) | |||
| No information | 4 | 17 | 4 | 17 | 3 | 13 | 5 | 2 | ||||||||||||||||
| Time of ART use during pregnancy | ||||||||||||||||||||||||
| <=15 days | 1 | 1.0 | 7 | 2.2 | 1 | 2 | 1.9 | 6 | 1.9 | 1 | 1 | 1.2 | 7 | 2.3 | 1 | 1 | 1.5 | 4 | 1.9 | 1 | ||||
| >15 days | 97 | 99.0 | 307 | 97.8 | 1.92 (0.27–13.77) | 102 | 98.1 | 302 | 98.1 | 1.01 (0.25–4.09) | 84 | 98.8 | 295 | 97.7 | 1.77 (0.25–12.73) | 67 | 98.5 | 206 | 98.1 | 1.23 (0.17–8.84) | ||||
| No information | 80 | 300 | 85 | 290 | 100 | 236 | 60 | 15 | ||||||||||||||||
| NRTI | ||||||||||||||||||||||||
| AZT | 158 | 303.8 | 550 | 252.3 | 1 | 171 | 275.8 | 533 | 260.0 | 1 | 174 | 98.9 | 473 | 92.9 | 1 | 1 | 101 | 84.2 | 194 | 91.5 | 1 | |||
| TDF | 7 | 13.5 | 32 | 14.7 | 0.8 (0.41–1.60) | 6 | 9.7 | 32 | 15.6 | 0.65 (0.29–1.47) | 2 | 1.1 | 36 | 7.1 | 0.2 (0.05–0.79) | 0.21 (0.05–0.83) | 19 | 15.8 | 18 | 8.5 | 1.5 (0.92–2.45) | |||
| No information | 13 | 32 | 12 | 33 | 9 | 29 | 8 | 13 | ||||||||||||||||
| ART during pregnancy | ||||||||||||||||||||||||
| NRTI+ NRTI + NVP | 28 | 17.4 | 110 | 19.7 | 1 | 34 | 20.0 | 103 | 18.9 | 1 | 38 | 4.1 | 79 | 2.9 | 1 | 20 | 2.6 | 3 | 0.2 | 1 | 1 | |||
| NRTI+ NRTI + NFV | 24 | 14.9 | 108 | 19.4 | 0.9 (0.52–1.55) | 28 | 16.5 | 102 | 18.8 | 0.87 (0.53–1.43) | 33 | 3.6 | 87 | 3.2 | 0.85 (0.53–1.35) | 28 | 3.6 | 3 | 0.2 | 1.04 (0.59–1.84) | 0.95 (0.5–1.81) | |||
| NRTI+ NRTI + LPV/R | 104 | 64.6 | 318 | 57.1 | 1.22 (0.80–1.84) | 103 | 60.6 | 319 | 58.6 | 0.98 (0.67–1.45) | 92 | 9.9 | 307 | 11.4 | 0.71 (0.49–1.04) | 63 | 8.2 | 198 | 14.7 | 0.28 (0.17–0.46) | 0.39 (0.19–0.79) | |||
| NRTI+ NRTI + ATV/R | 5 | 3.1 | 21 | 3.8 | 0.95 (0.37–2.46) | 5 | 2.9 | 20 | 3.7 | 0.81 (0.32–2.06) | 2 | 0.2 | 22 | 0.8 | 0.26 (0.06–1.06) | 5 | 0.7 | 15 | 1.1 | 0.29 (0.11–0.77) | 0.48 (0.14–1.62) | |||
| No information | 17 | 57 | 19 | 54 | 20 | 43 | 12 | 6 | ||||||||||||||||
| Birht weight | ||||||||||||||||||||||||
| >=2500 g | 139 | 75.5 | 427 | 79.4 | 1 | 99 | 78.0 | 177 | 78.7 | 1 | ||||||||||||||
| <2500 g | 45 | 24.5 | 111 | 20.6 | 1.18 (0.84–1.64) | 28 | 22.0 | 48 | 21.3 | 1.03 (0.68–1.56) | ||||||||||||||
| No information | 1 | 0 | 1 | 0 | ||||||||||||||||||||
| Gestational age at birth | ||||||||||||||||||||||||
| >=37 weeks | 126 | 68.5 | 428 | 80.0 | 1 | 1 | 104 | 81.9 | 171 | 76.3 | 1 | |||||||||||||
| <37 weeks | 58 | 31.5 | 107 | 20.0 | 1.55 (1.13–2.11) | 1.44 (1.04–1.99) | 23 | 18.1 | 53 | 23.7 | 0.8 (0.51–1.26) | |||||||||||||
| No information | 1 | 3 | 1 | 1 | ||||||||||||||||||||
| Mode of delivery | ||||||||||||||||||||||||
| Vaginal | 21 | 11.8 | 32 | 5.2 | 1.87 (1.18–2.94) | 1.96 (1.09–3.52) | 22 | 11.6 | 29 | 4.8 | 1.90 (1.22–2.97) | 1.43 (0.85–2.39) | 10 | 5.4 | 36 | 6.7 | 0.84 (0.45–1.59) | 12 | 9.4 | 9 | 4 | 1.64 (0.90–2.96) | ||
| Cesarean | 157 | 88.2 | 582 | 94.8 | 1 | 1 | 167 | 88.4 | 569 | 95.2 | 1 | 1 | 175 | 94.6 | 502 | 93.3 | 1 | 116 | 90.6 | 216 | 96 | |||
| Preterm labor | ||||||||||||||||||||||||
| No | 134 | 75.7 | 541 | 88.7 | 1 | 1 | 123 | 65.4 | 551 | 92.8 | 1 | 1 | 151 | 81.6 | 466 | 87.3 | 1 | 115 | 90.6 | 187 | 83.5 | 1 | ||
| Yes | 43 | 24.3 | 69 | 11.3 | 1.93 (1.37–2.73) | 2.08 (1.34–3.24) | 65 | 34.6 | 43 | 7.2 | 3.30 (2.44–4.45) | 3.33 (2.43–4.54) | 34 | 18.4 | 68 | 12.7 | 1.36 (0.94–1.98) | 12 | 9.4 | 37 | 16.5 | 0.64 (0.36–1.17) | ||
| No information | 1 | 4 | 1 | 4 | 0 | 4 | 1 | 1 | ||||||||||||||||
ART antiretroviral therapy, NRTI nucleos(t)ide reverse transcriptase inhibitors, AZT zidovudine, TDF tenofovir, NVP nevirapine, NFV nelfinavir, LPV lopinavir, ATV atazanavir, R ritonavir, CDC Centers for Disease Control and Prevention
*Cox Logistic Regression