Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers

Citation:
Stephen Gichuhi, Rose Bosire DM-N, Christine Gichuhi, Dalton Wamalwa, Maleche-Obimbo E, Farquhar C, Phelgona Otieno, Grace C. John-Stewart. "Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers." Ophthalmic Epidemiol. 2009 ; 16(6): 337–345. doi:10.3109/09286580903144746. 2009.

Abstract:

Abstract
Purpose—To determine the prevalence and correlates of neonatal conjunctivitis in infants born
to human immunodeficiency virus type 1 (HIV-1) infected mothers.
Methods—This was a nested case-control study within a perinatal HIV-1 cohort. HIV-1
seropositive mothers were enrolled during pregnancy and mother-infant pairs followed after
delivery with assessment for neonatal conjunctivitis at 48 hours and up to 4 weeks after birth.
Genital infections (chlamydia, gonorrhea, syphilis, trichomonas, bacterial vaginosis, and candida)
were screened for at 32 weeks gestation. Mothers received treatment for genital infections
diagnosed during pregnancy and short-course zidovudine. Newborns did not receive ocular
prophylaxis at hospital deliveries. Multivariate logistic regression models were used to determine
cofactors for neonatal conjunctivitis overall and stratified for infant HIV-1 status.
Results—Four hundred and fifty-two infants were assessed and 101 (22.3%) had neonatal
conjunctivitis during the first month postpartum. In multivariate analyses using odds ratios (OR)
and confidence intervals (CI), neonatal conjunctivitis was associated with neonatal sepsis
(adjusted OR 21.95, 95% CI 1.76, 274.61), birth before arrival to hospital (adjusted OR 13.91,
95% CI 1.39, 138.78) and birth weight (median 3.4 versus 3.3 kilograms, p=0.016, OR 1.79, 95%
CI 1.01, 3.15). Infant HIV-1 infection was not associated with conjunctivitis.
Conclusions—Despite detection and treatment of genital infections during pregnancy, neonatal
conjunctivitis was frequently diagnosed in infants born to HIV-1 infected mothers suggesting a
need for increased vigilance and prophylaxis for conjunctivitis in these infants. Neonatal sepsis,
birth before arrival to hospital, and higher birthweight are factors that may predict higher risk of
neonatal conjunctivitis in this population.

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