Risk Factors for Prematurity among Neonates from HIV Positive Mothers in Cameroon

Objective: Human immunodeficiency virus (HIV) infection is the most important chronic health condition among women in childbearing age in sub-Saharan Africa. There is sparse data about socio-economic factors in the context with adverse outcome in pregnancy. The objective of the study was to identify such factors for prematurity, low birth weight (LBW) and intrauterine growth retardation (IUGR) in infants born to HIV-positive women in Cameroon. Methods: The study was done in Yaoundé between December 2001 and November 2007. Neonates born to HIV-positive mothers were monitored and clinical data as well as socio-economic factors were tested for association with prematurity, LBW and IUGR. Findings: In total, 264 neonates were analyzed. More prematurity occurred when mothers attended less than 4 prenatal care visits (OR [95% CI]: 2.7 [1.21-6.05]; p=0.015). HIV-classification >1 resulted in more IUGR (OR [95% CI]): 3.15 [1.4-7.4]; p=0.01) and LBW (2.20 [1.1-4.6]; p=0.03). Single women were more likely to attend 4 prenatal care visits or more (OR [CI95%]: 2.4 [1.6-3.4]; p<0.001); higher education resulted in better compliance with anaemia prophylaxis (OR [CI95%]: 3.0 [1.5-5.8]; p=0.002) and antimalaria prophylaxis (OR [CI95%]: 2.1 [1.4-3.3]; p<0.001); and was associated with early HIV diagnosis (p=0.003). Conclusion: Prenatal care improves outcome in pregnancy of HIV-positive women. Single mothers compared to women in family settings are more likely to attend prenatal care visits, and HIV was diagnosed earlier in pregnancy in this population. More effort should be put to address women in family settings to early diagnose HIV and to increase compliance with prenatal care.