A retrospective study to determine whether there is an association between maternal HIV infection and neonatal hypoxic-ischaemic encephalopathy in a tertiary hospital in Johannesburg, South Africa

Hypoxic ischaemic encephalopathy (HIE) due to perinatal asphyxia is prevalent in South Africa. Almost one-third of mothers in South Africa are HIV-positive. This secondary analysis of an existing database sought to determine the association between maternal HIV status and neonatal HIE. There were 5846 neonates weighing more than 1800 g, and 824 (14.1%) had HIE. According to univariate analysis, more neonates without HIE than neonates with HIE were born to HIV-positive mothers (26.2% vs 22.6%, p 0.026). However, according to the binary logistic regression, the variables significantly associated with neonatal HIE were maternal age, vaginal delivery, maternal diabetes, and place of birth. There was no association between maternal HIV and neonatal HIE. This negative finding may be due to the high rate of prevention of mother-to-child transmission in the present study 95.2% of mothers received antiretroviral therapy during pregnancy. This study was a secondary analysis of an existing database from a single centre, so the results may not be generalizable. Factors such as maternal CD4 count, viral load, type and duration of antiretroviral therapy were not available for analysis.