{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:30:54Z","timestamp":1789608654036,"version":"build-2803163510"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U01AI096299"],"award-info":[{"award-number":["U01AI096299"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001070"],"award-info":[{"award-number":["UL1TR001070"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD105526"],"award-info":[{"award-number":["R01HD105526"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>In utero exposure to HIV and\/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adverse pregnancy outcomes among Rwandan women living with HIV (WLWH) and HIV-uninfected women and examines associations between HIV, ART timing, and LBW.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective cohort study used antenatal care, delivery, and PMTCT registry data from the Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA). Women with documented HIV status and recorded birth weights were included. Adverse outcomes were defined as LBW (&lt;2,500 g), stillbirth, and preterm birth (&lt;37 weeks gestation). Logistic regression was used to assess associations between maternal HIV status, ART timing, and LBW, adjusting for relevant covariates.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results and discussion<\/jats:title>\n<jats:p>Among 10,191 women with known HIV status and babies\u2019 birth weights, 12.7% (n\u2009=\u20091,293) were WLWH. There were 47 stillbirths (0.5%) and 70 preterm births (0.7%). Among 10,037 term births, 366 (3.6%) were LBW. WLWH had significantly higher rates of stillbirth (0.6% vs. 0.4%, p\u2009&lt;\u20090.05) and LBW (6.5% vs. 2.9%, p\u2009&lt;\u20090.001) compared to HIV-uninfected women; preterm birth rates did not differ significantly. The adjusted odds of LBW among WLWH were 1.61 (95% CI: 1.08, 2.39), controlling for marital status, primigravidae, and maternal weight at admission. Among WLWH (n\u2009=\u20091,274), ART initiation prior to pregnancy was associated with 50% lower odds of LBW after adjusting for age and WHO stage.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Even among relatively healthy uncomplicated pregnancies in low-risk delivery settings and universal ART, WLWH experienced significantly higher rates of stillbirth and LBW. Among WLWH, initiation of ART prior to current pregnancy had a protective effect against LBW. This underscores the importance of early HIV diagnosis and initiation of ART.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0329312","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T17:22:45Z","timestamp":1754932965000},"page":"e0329312","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5396-8304","authenticated-orcid":true,"given":"Natalia","family":"Zotova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanase","family":"Munyaneza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Murenzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gallican","family":"Kubwimana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adebola","family":"Adedimeji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Anastos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Yotebieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the CA-IeDEA consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"pone.0329312.ref001","unstructured":"World Health Organization. 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