An exploration of anaemia in low-birthweight infants exposed to perinatal zidovudine at the neonatal unit at a regional hospital in Durban

Abstract

Objective: The objective of the study was to determine the prevalence and degree of anaemia in low-birthweight neonates exposed to intrauterine zidovudine (AZT) at a regional hospital neonatal unit in Durban. Design: This was a descriptive, cross-sectional study. Background: Perinatal exposure to AZT has been shown to cause anaemia in full-term babies. The effects of AZT in this group need to be established as there is a low-birthweight rate of 12.8% of anaemia in South Africa. Outcome measures: Outcomes measures of the study were the neonatal haemoglobin (Hb) levels, gestational age and duration of AZT exposure. Results: The total prevalence of anaemia was 47% in the 95 neonatal birth records analysed. The prevalence of anaemia was 16.7% and a mean Hb of 17 g/dl in the 26-to 28-week gestational age category; a prevalence of anaemia of 37% with a mean Hb of 16 g/dl in the 29-to 31-week category; and a prevalence of 54.8% of anaemia with a mean Hb of 17 g/dl in the > 31-week category. The mean Hb in the neonates exposed to more than 28 days of AZT was lower than that in neonates exposed to less than 28 days in the 29-to 31-week and > 31-week gestational age categories. Conclusion:The haematological side-effects of neonatal anaemia resulting from intrauterine AZT exposure were mild and clinically insignificant in keeping with existing international and continental studies. The severity of anaemia in low-birthweight neonates appears to be the same as that in neonates with a normal birthweight. Current recommendations for the routine use of AZT for the prevention of mother-to-child transmission (PMTCT) of HIV are adequate, but further research involving larger numbers is needed.