Increased Risk of Low Birth Weight among Human Immunodeficiency Virus-Exposed Infants Between 2004 and 2021 in Hubei, China: A Retrospective Cohort Study

Increased Risk of Low Birth Weight among Human Immunodeficiency Virus-Exposed Infants Between 2004 and 2021 in Hubei, China: A Retrospective Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Increased Risk of Low Birth Weight among Human Immunodeficiency Virus-Exposed Infants Between 2004 and 2021 in Hubei, China: A Retrospective Cohort Study Jinli Liu, Songjie Wu, Shi Zou, Yajun Yan, Ling Feng, Wei Guo, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3658910/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Feb, 2025 Read the published version in BMC Public Health → Version 1 posted 11 You are reading this latest preprint version Abstract Background: Low birth weight (LBW, <2500g) is an essential indicator of neonatal death and poor infant development, but data on LBW among human immunodeficiency virus (HIV)-exposed infants in China is inadequate. Objective: This study aimed to explore the temporal trend and factors associated with the LBW among HIV-exposed infants in Hubei province, China. Methods: The pregnant women living with HIV in Hubei province, China between Jan 2004 and Dec 2021 were enrolled this study. Recruited HIV-positive women were provided with consultation about preventing mother-to-child transmission (PMTCT). The intervention measures for PMTCT were provided to pregnant women and HIV-exposed infants, and the LBW and HIV status of infants were followed. Collected data included women’s demographic information, HIV status of sexual partner, route of HIV transmission, HBV infection, HCV infection, syphilis infection, intrapartum CD4 count, whether received antiretroviral therapy (ART), the time of ART initiation, and ART regimens during pregnancy. Multivariable logistic regression was used to analyze factors associated with the LBW. Results: In total, 531 mothers (581 pregnancy events) and 581 infants were enrolled. The mean birth weight and LBW rate were 3075±470.2g and 8.4%, respectively. From 2004 to 2021, a significantly increased LBW rate (4.7% to 14.0%, P =.004) was observed. The use of protease inhibitor (PI)-based regimen ( P =.04) and the exposure to ART in the first trimester ( P =.01) were positively correlated with the increase of LBW rate. Exposure to ART in the first trimester (adjusted odds ratio [aOR] 3.64, 95%CI 1.29-10.27) and the second trimester (aOR 4.53, 95%CI 1.52-13.48), premature delivery (aOR 48.44, 95%CI 16.98-138.18), and infant with HIV infection (aOR 5.91, 95%CI 1.55-22.58) were predictors for LBW. Conclusions: The significantly increased LBW rate in our study indicated that specific attention should be paid to HIV-exposed infants in China. More importantly, our study identified significant factors that can predict the risk of LBW. Interventions targeting these risk factors may prevent LBW among pregnant women living with HIV in future research and prenatal care. low birth weight HIV-exposed infants antiretroviral therapy protease inhibitor Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryTable1.pdf Cite Share Download PDF Status: Published Journal Publication published 14 Feb, 2025 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 14 Nov, 2024 Reviews received at journal 13 Nov, 2024 Reviewers agreed at journal 24 Oct, 2024 Reviews received at journal 25 Dec, 2023 Reviewers agreed at journal 19 Dec, 2023 Reviewers agreed at journal 10 Dec, 2023 Reviewers invited by journal 10 Dec, 2023 Editor assigned by journal 10 Dec, 2023 Editor invited by journal 02 Dec, 2023 Submission checks completed at journal 02 Dec, 2023 First submitted to journal 24 Nov, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3658910","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":255928123,"identity":"89ca58f2-d7f2-4d69-8634-fcb054ecbf83","order_by":0,"name":"Jinli Liu","email":"","orcid":"","institution":"Zhongnan Hospital of Wuhan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jinli","middleName":"","lastName":"Liu","suffix":""},{"id":255928125,"identity":"18f0a502-d4ed-4838-96cf-f6f732a05d4a","order_by":1,"name":"Songjie Wu","email":"","orcid":"","institution":"Zhongnan Hospital of Wuhan 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11:59:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3658910/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3658910/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-21707-6","type":"published","date":"2025-02-14T15:58:12+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":76487668,"identity":"3a8b4ee8-b7e4-43b0-988d-d8790292c7a7","added_by":"auto","created_at":"2025-02-17 16:10:53","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":494663,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3658910/v1_covered_bb11b77e-ee2d-4951-83a7-53781a9d5c0c.pdf"},{"id":47602213,"identity":"fe250d1c-ce65-4cda-9a3f-b7f89dca25f0","added_by":"auto","created_at":"2023-12-05 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Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"low birth weight, HIV-exposed infants, antiretroviral therapy, protease inhibitor","lastPublishedDoi":"10.21203/rs.3.rs-3658910/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3658910/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eLow birth weight (LBW, \u0026lt;2500g) is an essential indicator of neonatal death and poor infant development, but data on LBW among human immunodeficiency virus (HIV)-exposed infants in China is inadequate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eThis study aimed to explore the temporal trend and factors associated with the LBW among HIV-exposed infants in Hubei province, China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe\u003cstrong\u003e \u003c/strong\u003epregnant women living with HIV in Hubei province, China between Jan 2004 and Dec 2021 were enrolled this study. Recruited HIV-positive women were provided with consultation about preventing mother-to-child transmission (PMTCT). The intervention measures for PMTCT were provided to pregnant women and HIV-exposed infants, and the LBW and HIV status of infants were followed. Collected data included women’s demographic information, HIV status of sexual partner, route of HIV transmission, HBV infection, HCV infection, syphilis infection, intrapartum CD4 count, whether received antiretroviral therapy (ART), the time of ART initiation, and ART regimens during pregnancy. Multivariable logistic regression was used to analyze factors associated with the LBW.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eIn total, 531 mothers (581 pregnancy events) and 581 infants were enrolled. The mean birth weight and LBW rate were 3075±470.2g and 8.4%, respectively. From 2004 to 2021, a significantly increased LBW rate (4.7% to 14.0%, \u003cem\u003eP\u003c/em\u003e=.004) was observed. The use of protease inhibitor (PI)-based regimen (\u003cem\u003eP\u003c/em\u003e=.04) and the exposure to ART in the first trimester (\u003cem\u003eP\u003c/em\u003e=.01) were positively correlated with the increase of LBW rate. Exposure to ART in the first trimester (adjusted odds ratio [aOR] 3.64, 95%CI 1.29-10.27) and the second trimester (aOR 4.53, 95%CI 1.52-13.48), premature delivery (aOR 48.44, 95%CI 16.98-138.18), and infant with HIV infection (aOR 5.91, 95%CI 1.55-22.58) were predictors for LBW.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThe significantly increased LBW rate in our study indicated that specific attention should be paid to HIV-exposed infants in China. More importantly, our study identified significant factors that can predict the risk of LBW. Interventions targeting these risk factors may prevent LBW among pregnant women living with HIV in future research and prenatal care.\u003c/p\u003e","manuscriptTitle":"Increased Risk of Low Birth Weight among Human Immunodeficiency Virus-Exposed Infants Between 2004 and 2021 in Hubei, China: A Retrospective Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-12-05 03:42:27","doi":"10.21203/rs.3.rs-3658910/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-14T17:50:44+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-14T04:15:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180587170332839588641944006782516036976","date":"2024-10-24T05:03:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-12-25T12:50:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"55d58d81-f773-4ce8-b202-069e25524d27","date":"2023-12-19T13:47:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"74fc37cc-ae25-474f-b0a5-103d487bd1ef","date":"2023-12-10T15:25:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-12-10T14:43:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-12-10T14:33:42+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-12-02T12:32:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-12-02T12:28:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2023-11-24T11:52:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e1742871-5fc8-4b67-b345-00c830bb2afd","owner":[],"postedDate":"December 5th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-17T16:05:14+00:00","versionOfRecord":{"articleIdentity":"rs-3658910","link":"https://doi.org/10.1186/s12889-025-21707-6","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-02-14 15:58:12","publishedOnDateReadable":"February 14th, 2025"},"versionCreatedAt":"2023-12-05 03:42:27","video":"","vorDoi":"10.1186/s12889-025-21707-6","vorDoiUrl":"https://doi.org/10.1186/s12889-025-21707-6","workflowStages":[]},"version":"v1","identity":"rs-3658910","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3658910","identity":"rs-3658910","version":["v1"]},"buildId":"ehx78VzkSd0WSzXnipQa-","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}