Yan, H;
Peters, H;
Thorne, C;
(2022)
Neonatal deaths among infants born to women living with HIV in the UK and Ireland 1998–2017.
AIDS
, 36
(2)
pp. 287-296.
10.1097/QAD.0000000000003095.
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Abstract
OBJECTIVES: To estimate the incidence of neonatal mortality among infants born to women living with HIV in the UK and Ireland in 1998-2017, describe causes of neonatal death (NND) and examine risk factors. DESIGN: Population-based surveillance of pregnancies in diagnosed women living with HIV and their infants in the UK and Ireland. METHODS: Estimated yearly incidence of NND was reported for 1998-2017 and causes coded using the World Health Organization International Classification of Perinatal Mortality. Risk factor analyses used multivariable logistic regression, including delivery year, maternal origin, maternal age, delivery CD4 count and viral load (VL), antiretroviral therapy (ART) at conception, preterm delivery (PTD), injecting drug use and infant sex. RESULTS: There were 20,012 live-born infants delivered to 12,684 mothers in 19,601 pregnancies. The overall neonatal mortality rate was 4.10 per 1000 livebirths (95%CI, 3.2-5.0), which was higher than that of the general population. Prematurity was the leading cause of death followed by congenital abnormality. Most NND occurred on the first day of life. ART at conception was associated with significantly reduced NND risk. In a restricted 2007-2017 analysis including VL, PTD and detectable maternal VL were associated with significantly increased NND risk. CONCLUSIONS: The vertical transmission rate in the UK, at 3 per 1000, is now lower than the neonatal mortality rate among infants born to women with HIV. More research is needed to investigate the complex relationship between ART, preterm delivery and neonatal death in order to improve all perinatal outcomes.
| Type: | Article |
|---|---|
| Title: | Neonatal deaths among infants born to women living with HIV in the UK and Ireland 1998–2017 |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000003095 |
| Publisher version: | https://doi.org/10.1097/QAD.0000000000003095 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10136801 |
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