Perinatal findings in children born to HIV-infected mothers. The European Collaborative Study

OBJECTIVE: To explore in children born to HIV-infected women, the association between a child's HIV infection status and birthweight, gestational age, congenital abnormalities and other perinatal findings. DESIGN: A prospective study of children born to women known to be HIV-infected at or before the time of delivery enrolled in the European Collaborative Study. SETTING: Nineteen European centres. SUBJECTS: A cohort of 853 children with known HIV infection status. RESULTS: There was no evidence for an HIV dysmorphic syndrome, and the frequency of congenital abnormalities was similar in infected and uninfected children with no consistent pattern of defects. Injecting drug use during pregnancy had the most marked effect on birthweight and gestational age. Multivariate analysis demonstrated a weak association between birthweight and the child's HIV infection status, but this could partly be explained by the confounding effect of maternal immunological HIV status. HIV infection in the infant was not associated with gestational age, and the mean and distribution of gestational age were similar for infected and noninfected children. CONCLUSIONS: The finding that HIV-infected and noninfected children are of similar birthweight, the absence of a dysmorphic syndrome and no evidence of associated congenital abnormalities suggest that a substantial proportion of infection occurs late in pregnancy or at the time of delivery