RESEARCH: HIV and Child Health

Birth Outcomes: An Analysis of Risk Factors for Adverse Pregnancy Outcomes among HIV-infected and HIV-uninfected Women in Botswana and 2-year Infant Mortality by HIV Exposure, PMTCT Prophylaxis Strategy, and Feeding Method

Principle Investigator: Roger Shaprio
Funding: CDC

Objectives:
1) A prospective chart review on delivery wards of birth outcomes, 2) a sub-study of laboratory testing and verbal autopsies to identify risk factors for stillbirths by HIV status, and 3) a prospective sub-study to follow HIV-exposed and HIV-unexposed infants for 2 years to identify risks for early mortality.

Part A: Birth Surveillance and Stillbirths: High rates of stillbirths and neonatal mortality have been identified in Botswana. HIV infection, infant formula, and possibly antiretrovirals used for the prevention of mother-to-child HIV transmission (PMTCT) may contribute to neonatal deaths, and HIV infection and possibly antiretrovirals may contribute to stillbirths. The study will describe factors associated with adverse birth outcomes and neonatal deaths in Botswana.

Part B: Infant Mortality: High infant mortality, particularly among HIV-exposed infants, is a concern in Botswana. This study will describe 2-year morbidity and mortality among children in Botswana who are HIV-unexposed, HIV-exposed but uninfected, and HIV-infected. It will also describe survival by infant feeding strategy among HIV-exposed and HIV-unexposed children, and HIV-free survival by PMTCT strategy among HIV-exposed children.

Enrollment: October 2007 - present

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