Paper Title
Factors and Correlates of Composite Adverse Birth Outcomes with HIV and Associated Co-Morbidities Among Postnatal Women Attending Selected Maternal Facility, Nairobi, Kenya

Objective: The objective of this study was to determine the risk of neonatal mortality and other composite adverse birth outcomes and association with HIV infection among postnatal women attending selected maternity facility Design: This was an unmatched case-control study. Setting: Pumwani Maternity Hospital, Nairobi County, Kenya Subjects: Two hundred and fifty-six (256) participants were enrolled in the study by virtue of extracting information from the hospital records. This was done after pre-testing the information abstraction tool on the risk of neonatal mortality and its association with HIV infection among the postnatal women in terms of the neonatal mortality (outcome). Results: There was a risk of neonatal mortality in association with HIV infection among postnatal women as compared to non HIV infection of the total (21) HIV positive mothers (cases=128 and controls=128) at 12.5% and 3.9%, respectively at bivariate analysis ([OR= 3.51; 95%CI: 1.25-9.91; P=0.012]). This was not sustained though at multivariate analysis with potential confounders in the study. Conclusion: Out of 128 cases, 16(12.5%) were born from HIV positive mothers as compared to 5(3.9%) 0f the 128 controls. Therefore, HIV positivity was found to be significantly associated with neonatal mortality in bivariate analysis, but was not significant after adjustment was made for other factors at the multivariate analysis. Multiple logistic regressions revealed the following factors as independent predictors of neonatal mortality: LBW (41.4%), [AOR= 3.97] Infections/comorbidities, [AOR=3.84], Mother’s hemoglobin level, [AOR=3.18] Unemployment, [AOR=0.43].