Newborn anthropometry and early outcomes in HIV-exposed newborns receiving PMTCT care

Abstract

Objectives: Maternal human immunodeficiency virus (HIV) infection remains associated with adverse birth outcomes in many low-resource settings. Despite widespread use of highly active antiretroviral therapy (HAART) as part of prevention of mother-to-child transmission (PMTCT) measures, its effects on newborn anthropometry and early birth outcomes are not fully defined. This study compared anthropometric parameters, gestational age (GA) at birth, sex, and Appearance-Pulse-Grimace-Activity-Respiration (APGAR) scores between HIV-exposed and HIV-unexposed newborns; explored differences by maternal antiretroviral therapy exposure among HIV-exposed newborns; and examined factors associated with birth weight in both groups. Material and Methods: This was a comparative observational study with record abstraction, which included 144 mother–newborn pairs comprising 48 HIV-exposed and 96 HIV-unexposed newborns. Maternal demographic and obstetric data were obtained from medical records. Newborn assessments included birth weight, head circumference, chest circumference, body length, sex, GA, and APGAR scores at 1, 5, and 10 min. Statistical analyses involved cross-tabulations, Pearson correlation analyses, and multivariable linear regression. Results: HIV-exposed newborns had significantly lower mean birth weight (2.94 ± 0.62 kg vs. 3.26 ± 0.38 kg), smaller head circumference (32.93 ± 2.17 cm vs. 34.11 ± 1.78 cm), and shorter body length (49.13 ± 3.99 cm vs. 50.68 ± 2.49 cm) compared with HIV-unexposed newborns ( p < 0.05). APGAR scores at 1 and 5 min were also significantly lower among HIV-exposed newborns. No statistically significant differences were detected between newborns of antiretroviral-treated and untreated HIV-positive mothers; however, these comparisons were imprecise due to small subgroup numbers and clinical heterogeneity and are interpreted as exploratory. GA and anthropometric measures showed significant correlations with birth weight in both groups. Multivariable regression identified sex, GA, head circumference, chest circumference, and body length as independent factors associated with birth weight (R 2 = 0.832, p < 0.001). Conclusion: In this cohort, maternal HIV status was associated with differences in newborn anthropometry and APGAR scores, indicating that HIV-exposed newborns may require enhanced perinatal assessment and monitoring in resource-limited PMTCT settings. These findings underscore the need for strengthened antenatal care and targeted perinatal monitoring for HIV-exposed newborns in resource-limited PMTCT settings.