       Document 0788
 DOCN  M9610788
 TI    Maternal HIV infection and infant mortality in Malawi: evidence for
       increased mortality due to placental malaria infection.
 DT    9601
 AU    Bloland PB; Wirima JJ; Steketee RW; Chilima B; Hightower A; Breman JG;
       Division of Parasitic Diseases, National Center for Infectious;
       Diseases, Centers for Disease Control and Prevention, Atlanta, GA;
       30341-3724, USA.
 SO    AIDS. 1995 Jul;9(7):721-6. Unique Identifier : AIDSLINE MED/96035235
 AB    OBJECTIVES: To examine the relationship between maternal HIV infection,
       placental malaria infection, and infant mortality as a first step in
       investigating the possibility of increased vertical transmission of HIV
       due to placental malaria infection. DESIGN: Retrospective analysis of
       data from a cohort study of mothers and infants in rural Malawi
       conducted from 1987 to 1990. METHODS: Pregnant women in Malawi were
       enrolled in a study examining chemoprophylaxis during pregnancy. At
       delivery, placental malaria infection status was determined. Infants
       born into this study were visited every 2 months for the first 2-3 years
       of life. Deaths were investigated using a standardized 'verbal autopsy'
       interview. Maternal serum collected during pregnancy was tested for
       antibodies to HIV-1 by enzyme-linked immunosorbent assay with Western
       blot confirmation. RESULTS: Overall, 138 (5.3%) of 2608 women in the
       study were HIV-1-seropositive. Infant mortality rates were 144 and 235
       per 1000 live births for children born to HIV-seronegative and
       HIV-seropositive women, respectively (P < 0.001). In a multivariate
       model, the odds of dying during the post-neonatal period for an infant
       born to a mother with both placental malaria and HIV infection was 4.5
       times greater than an infant born to a mother with only placental
       malaria, and between 2.7 and 7.7 times greater (depending on
       birthweight) than an infant born to a mother with only HIV infection.
       CONCLUSIONS: This study strongly suggests that exposure to both
       placental malaria infection and maternal HIV infection increases
       post-neonatal mortality beyond the independent risk associated with
       exposure to either maternal HIV or placental malaria infection. If
       confirmed, malaria chemoprophylaxis during pregnancy could decrease the
       impact of transmission of HIV from mother to infant.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY  Adult  Comorbidity
       Female  Human  *Infant Mortality  Infant, Newborn  Malaria,
       Falciparum/*EPIDEMIOLOGY  Malawi/EPIDEMIOLOGY  Pregnancy  Pregnancy
       Complications, Infectious/*EPIDEMIOLOGY  Pregnancy Complications,
       Parasitic/*EPIDEMIOLOGY  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       Non-P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

