Table 4:
Logistic regression models assessing (A) the association of HIV exposure with different outcomes of interest among neonates HIV exposed uninfected (HEU) and HIV unexposed uninfected and (B) the association of maternal HIV-related factors with different outcomes of interest among neonates HEU
| (A) | Neonatal admission (N=894)* |
Neonatal infection-related admission (N=894)* |
Neonatal ICU admission (N=894)* |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|
| uaOR | 95% CI | aOR | 95% CI | uaOR | 95% CI | aOR | 95% CI | uaOR | 95% CI | aOR | 95% CI | |
| HIV exposure | 0.74 | (0.50–1.08) | 0.65 | (0.43–0.97) | 0.75 | (0.40–1.41) | 0.65 | (0.33–1.25) | 1.62 | (0.88–2.97) | 1.50 | (0.79–2.85) |
| Maternal age (years) | 1.03 | (0.99–1.06) | 1.03 | (1.00–1.07) | 1.02 | (0.97–1.07) | 1.02 | (0.97–1.08) | 1.01 | (0.96–1.06) | 1.00 | (0.94–1.05) |
| Maternal education (secondary schooling completed) | 0.95 | (0.64–1.43) | 0.95 | (0.63–1.44) | 0.83 | (0.43–1.63) | 0.79 | (0.40–1.56) | 0.81 | (0.43–1.54) | 0.84 | (0.43–1.63) |
| Reside in formal housing (vs informal) | 0.89 | (0.61–1.31) | 0.90 | (0.60–1.33) | 1.17 | (0.63–2.18) | 1.21 | (0.64–2.27) | 0.89 | (0.49–1.62) | 0.95 | (0.51–1.75) |
| Twin | 6.76 | (2.75–16.60) | 6.28 | (2.47–15.96) | 5.52 | (1.76–17.31) | 6.19 | (1.92–19.94) | 6.80 | (2.36–19.61) | 6.90 | (2.33–20.40) |
| Preterm birth (N=903)# |
Very preterm birth (N=903)# |
Death (N=903)# |
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| uaOR | 95% CI | aOR | 95% CI | uaOR | 95% CI | aOR | 95% CI | uaOR | 95% CI | aOR | 95% CI | |
| HIV exposure | 1.35 | (0.90–2.02) | 1.12 | (0.73–1.73) | 1.82 | (0.76–4.39) | 1.55 | (0.60–3.96) | 1.03 | (0.30–3.57) | 0.90 | (0.23–3.42) |
| Maternal age (years) | 1.05 | (1.02–1.09) | 1.04 | (1.00–1.08) | 1.03 | (0.96–1.11) | 1.00 | (0.93–1.09) | 1.04 | (0.94–1.16) | 1.04 | (0.93–1.16) |
| Maternal education (secondary schooling completed) | 0.69 | (0.44–1.07) | 0.69 | (0.43–1.10) | 0.69 | (0.27–1.79) | 0.67 | (0.25–1.82) | 1.25 | (0.35–4.45) | 1.01 | (0.27–3.81) |
| Reside in formal housing (vs informal) | 1.05 | (0.70–1.56) | 1.16 | (0.76–1.76) | 1.17 | (0.50–2.72) | 1.36 | (0.56–3.31) | 4.72 | (1.00–22.36) | 5.11 | (1.04–25.06) |
| Twin | 15.28 | (5.95–39.24) | 13.25 | (5.01–35.01) | 17.034 | (5.56–52.23) | 17.56 | (5.49–56.13) | 12.19 | (2.42–61.51) | 13.42 | (2.47–73.02) |
| (B) | Preterm birth (N=402)# |
Very preterm birth (N=402)# |
Neonatal ICU admission (N=400)* |
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| uaOR | 95% CI | aOR^ | 95% CI | uaOR | 95% CI | aOR† | 95% CI | uaOR | 95% CI | aOR† | 95% CI | |
| Maternal age (years) | 1.06 | (1.01–1.11) | 1.06 | (0.99–1.12) | 1.02 | (0.93–1.13) | 1.04 | (0.92–1.17) | 1.01 | (0.94–1.08) | 1.02 | (0.94–1.00) |
| Maternal education (secondary schooling completed) | 0.74 | (0.40–1.38) | 0.40 | (0.18–0.88) | 0.38 | (0.08–1.74) | 0.34 | (0.07–1.69) | 0.64 | (0.25–1.61) | 0.52 | (0.18–1.47) |
| Reside in formal housing (vs informal) | 0.97 | (0.56–1.68) | 1.20 | (0.64–2.26) | 0.99 | (0.34–2.89) | 1.36 | (0.41–4.50) | 0.85 | (0.39–1.86) | 1.16 | (0.50–2.70) |
| Twin | 11.50 | (3.62–36.46) | 13.69 | (3.70–50.75) | 18.84 | (4.96–71.56) | 22.78 | (4.26–121.67) | 7.56 | (2.17–26.31) | 6.07 | (1.41–26.19) |
| Receiving ART at conception | 1 | 1 | 1 | |||||||||
| Initiated ART during pregnancy | 0.77 | (0.39–1.53) | 1.12 | (0.32–3.91) | 1.86 | (0.79–4.34) | ||||||
| Previous ART history, resumed ART during pregnancy | 1.52 | (0.79–2.94) | 1.23 | (0.31–4.86) | 1.19 | (0.41–3.47) | ||||||
| Receiving ART at conception | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| Initiated/resumed ART in first trimester | 2.10 | (0.99–4.44) | 3.38 | (1.37–8.33) | 2.95 | (0.83–10.48) | 3.80 | (0.79–18.28) | 3.13 | (1.16–8.40) | 2.68 | (0.83–8.62) |
| Initiated/resumed ART in second trimester | 0.71 | (0.36–1.38) | 0.76 | (0.35–1.67) | 0.72 | (0.18–2.81) | 0.65 | (0.15–2.86) | 1.27 | (0.52–3.09) | 1.13 | (0.42–3.00) |
| Initiated/resumed ART in third trimester | 1.62 | (0.43–6.05) | - | - | - | - | - | |||||
| CD4 ≥200 | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| CD4 <200 | 1.60 | (0.70–3.65) | 0.90 | (0.30–2.66) | 0.78 | (0.10–6.17) | 0.33 | (0.04–3.04) | 1.78 | (0.58–5.45) | 0.99 | (0.25–3.90) |
| CD4>500 | 1 | 1 | 1 | |||||||||
| CD4 350–499 | 0.93 | (0.46–1.89) | 0.23 | (0.03–1.84) | 0.51 | (0.16–1.60) | ||||||
| CD4 200–349 | 1.10 | (0.52–2.29) | 0.88 | (0.23–3.38) | 0.65 | (0.21–2.03) | ||||||
| CD4 <200 | 1.59 | (0.66–3.83) | 0.59 | (0.07–4.86) | 1.40 | (0.44–4.49) | ||||||
| VL <400 before delivery | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
| VL ≥400 before delivery | 1.31 | (0.58–2.95) | 2.29 | (0.84–6.20) | 2.08 | (0.56–7.72) | 6.30 | (1.28–30.96) | 0.91 | (0.27–3.15) | 1.40 | (0.36–5.51) |
| VL <40 before delivery | 1 | 1 | 1 | |||||||||
| VL 40–399 | 1.30 | (0.59–2.84) | - | 0.74 | (0.21–2.55) | |||||||
| VL 400–999 | 2.45 | (0.48–12.56) | 3.97 | (0.45–35.15) | 2.00 | (0.23–17.03) | ||||||
| VL ≥1000 | 1.19 | (0.47–3.01) | 1.36 | (0.29–6.34) | 0.68 | (0.15–3.02) | ||||||
| NNRTI-based regimen | 1 | 1 | - | - | ||||||||
| PI-based regimen | 4.57 | (1.89–11.10) | 5.08 | (1.90–13.58) | - | - | ||||||
Abbreviations - ICU: intensive care unit; uaOR: unadjusted odds ratio; CI: confidence interval; aOR: adjusted odds ratio; ART: antiretroviral treatment; VL: viral load; NNRTI: non-nucleoside reverse transcriptase inhibitor; PI: protease inhibitor
excluding neonates born in other provinces (n=7;2), second-born twins (n=6;12) and neonates with severe congenital anomalies requiring urgent surgical intervention (n=1;4: intestinal atresia; imperforate anus; 2 x myelomeningocele; cleft palate)
excluding second-born twins (n=6;12) and neonates with severe congenital anomalies requiring urgent surgical intervention (n=1;4)
third trimester ART initiation could not be included in the adjusted model as it predicted preterm delivery perfectly (zero events)
regimen type and third trimester ART initiation could not be included in the adjusted model as they predicted very preterm delivery and ICU admission perfectly (zero events)