Hemoglobin level and correlates of low birth weight with HIV infection and associated co-morbidity(s) among postnatal women attending a selected maternal facility, NAIROBI, KENYA

ABSTRACT: 

Maternal HIV and related co-morbidities has contributed to several adverse birth outcomes with paucity of data to explain this phenomenon. PMTCT focus on vertical HIV transmission, but no data on poor birth outcomes on HIV and hemoglobin as associated morbidity. With a number of studies having investigated correlations of HIV disease with birth outcomes, an extensive assessment using a comparative group (controls) is lacking. In the current study, estimation of HIV and related co-morbidities risks of adverse birth outcomes in among post-natal women was reviewed with the ultimatum outcome being neonatal mortality and a focus on hemoglobin level as predictor. Methodology & Theoretical Orientation: Design was unmatched case control record review. The information was extracted from records of the study subjects within the first twenty-eight days after birth randomly and considering age, sex, anthropometric measurements and other clinical factors of the newborn and mother. A total of 256 records were reviewed retrospectively on cases and controls at 1:1 ratio. Mothers’ pregnancy history, clinical and social economic, co morbidities and health factors were considered for both arms. The data was analyzed using SPSS version 20.0. Chi-square test was used to establish the correlation between the dependent and independent variables at (SS) p-value < 0.05. Multiple logistic regression analyses were performed to adjust for confounding. AOR with corresponding 95% confidence interval was estimated. Findings: Out of 128 cases (neonatal mortalities) 12.5% were born from HIV-positive mothers compared to 3.9% among 128 controls HIV was significantly correlated with neonatal mortality in bivariate analysis [OR= 3.51; 95%CI: 1.25-9.91; P=0.012] but not sustained after adjusting for other factors at the multivariate analysis [AOR=2.33; 95%CI: 0.76-7.15; P=0.139].Multiple logistic regression revealed; LBW [AOR= 3.97; 95%CI: 2.26-6.98; P< 0.001], co-morbidities[AOR= 3.84; 95%CI: 1.32- 11.16; P=0.013]. Mother's hemoglobin level [AOR= 3.18; 95%CI: 1.19-8.46; P=0.021], unemployment [AOR=0.43; 95%CI: 0.22-0.85; P=0.016]. There’s increased risk of neonatal mortality and related morbidities with HIV infection with poor hemoglobin levels among postnatal women.

Keywords: Mortality, Neonatal, Postnatal HIV-Infection, hemoglobin level