Impact of Maternal Human Immunodeficiency Virus Infection on Birth Outcomes and Infant Survival in Rural Mozambique

Denise Naniche Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Azucena Bardají Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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María Lahuerta Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Anna Berenguera Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Inacio Mandomando Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Sergi Sanz Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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John J. Aponte Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Betuel Sigauque Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Pedro L. Alonso Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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Clara Menéndez Barcelona Center for International Health Research, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain; Centro de Investigaçâo em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde Maputo, Mozambique; Faculdade de Medicina da Universidade Eduardo Mondlane, Maputo, Mozambique

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We assessed the effect of maternal human immunodeficiency virus (HIV) infection on birth outcomes and infant survival in rural Mozambique. Pregnant women attending the antenatal clinic were recruited. These women and their infants were followed-up for one year. Birth outcomes were assessed at delivery and infant HIV status was determined at 1 and 12 months of age. Women positive for HIV were more likely to have anemia at delivery than women negative for HIV (51.3% versus 35.4%; P < 0.001). Infants born to HIV-positive mothers had a significantly higher post-neonatal mortality rate than infants born to HIV-negative mothers (7.8% versus 1.9%; P < 0.001). The rate of transmission of HIV by breastfeeding during the first year of life was 15.1% (95% confidence interval = CI 7.6–22.4). Assessment of the impact of HIV infection on birth outcomes in rural Africa is essential for tailoring public health measures to reduce mother-to-child transmission of HIV and excess infant mortality.

Author Notes

Reprints requests: Denise Naniche, Barcelona Centre for International Health, Institut d’Investigacions Biomèdiques August Pi i Sunyer/ Hospital Clinic, Villarroel, 170 Barcelona, E-08036 Spain, E-mail: dsuzanne@clinic.ub.es.
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