Introduction A maternal HIV infection may have two outstanding consequences to fetal health: mother-to-child transmission and adverse perinatal outcome. After the success in reducing mother-to-child transmission the attention must now be diverted to the high proportion of HIV-exposed children that are born preterm or with fetal growth restriction.

Objective To determine the prevalence of preterm birth and fetal growth restriction in low income, antiretroviral users, HIV-infected women and to verify its relation to the HIV infection stage and comorbidity.

Patients and Methods Out of 250 deliveries from HIV-infected mothers at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, we included 109 (43.6%) single pregnancies with data about the gestational age, HIV status, antiretroviral use, and fetal dimensions. Data were extracted from clinical and pathological records, the gestation age estimated and the fetal dimensions classified as small, adequate, and large for gestational age according to the pertinent reference standard.

Results Preterm birth was observed in 17.4%, low birth weight in 23.9% and small for gestational weight, length, and cephalic and abdominal circumferences in 22.0%, 29.0%, 1.0%, and 43.6%, respectively, without significant variation according to the HIV infection severity or the existence of comorbidity. The concomitant distribution of small for gestational weight, length and abdominal circumference points to an asymmetrical fetal growth restriction.

Conclusions The prevalence of preterm birth and growth restriction were higher than the Espirito Santo State liveborn Registry prevalence and the expected population distribution in the gestations of HIV-infected, low income, ART users, and publicly assisted pregnant women in this casuistry.