Edna N Matjuda, Godwill A Engwa, Nandu Goswami, Constance R Sewani-Rusike, Benedicta N Nkeh-Chungag
Newborns of HIV-infected mothers on ART were more likely to have low birth weight than newborns of HIV-uninfected mothers, suggesting an association of ART with low birth weight in newborns. In utero exposure of the foetus to ART might have influenced low birth weight in newborns through the promotion of endothelial dysfunction and oxidative stress.
OBJECTIVES: This study investigated the effects of ART on the cardiometabolic health of HIV-infected women during late pregnancy and its relationship with adverse outcomes in exposed newborns.
METHODS: This was a cross-sectional study conducted among pregnant women living with HIV (pWLWH) on ART and HIV-uninfected pregnant women (controls) in their third trimester. Data on maternal gynaeco-obstetric history and cardiovascular health were collected. At birth, anthropometric measures and placental cord blood samples from newborns were collected to assess lipidaemia, glycaemia, oxidative stress, endothelial function, and inflammatory markers.
RESULTS: More pWLWH had previously had hypertension compared (p>0.05) to HIV-uninfected pregnant women (HUPW). Blood creatinine and 8-hydroxydeoxyguanosine were higher, while tumour necrosis factor-alpha and vascular endothelial growth factor receptor were lower in newborns of HIV-infected mothers on ART (HIMA) compared to newborns of HIV-uninfected mothers (HUM) (p<0.05). Similarly, the APGAR scores after 1 and 5 min were lower in newborns of HIMA compared to newborns of HUM (p<0.05). The prevalence of low birth weight (LBW) was higher (p<0.05) in newborns of HIMA (13.2 %) compared to newborns of HUM (8.2 %). Newborns of HIMA were 3.3 times (OR: 3.302; p<0.01) more likely to present LBW compared to newborns of HUM.
CONCLUSIONS: Newborns of HIV-infected mothers on ART were more likely to have low birth weight than newborns of HIV-uninfected mothers, suggesting an association of ART with low birth weight in newborns. In utero exposure of the foetus to ART might have influenced low birth weight in newborns through the promotion of endothelial dysfunction and oxidative stress.