Pregnancy outcomes in HIV positive women remain a concern especially in sub-Saharan Africa which bears the highest burden of the disease. To evaluate pregnancy outcomes in booked pregnant women on Highly Active Antiretroviral Therapy (HAART) at the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria; a case control study (with women initiating HAART in pregnancy as subjects and those who initiated it before pregnancy as control) of 268 HIV-positive women managed between March 2009 and February 2013 was undertaken at the hospital. Inclusion criteria comprised HIV-positivity, booking, antenatal care and delivery at the study site. From the total of 8,958 women who had antenatal care during the period, 502 had HIV infection (prevalence 5.6%) out of which 268 satisfied the inclusion criteria and were enrolled into the study. Subjects were 54(20.2%) while 214(79.8%) were controls; the mean age of participants was 31.0±4.5 years while mean parity was 2.0±1.5. Pregnancy outcomes were worse in subjects with statistical significance in miscarriage (11.1% vs. 0.9%; OR 11.78, 95% CI 2.07-87.03, p <0.01), preterm delivery (31.5% vs. 1.9%; OR 24.35, 95% CI 7.15-91.26, p<0.01), term pregnancy (42.6% vs. 96.3%; OR 0.03, 95% CI 0.01-0.08, p<0.01), birth asphyxia (OR 8.31, 95% CI 3.25-21.45 p<0.01), low birth weight babies (OR 260.0, 95% CI 66.51-1142.77, p<0.01) and maternal puerperal complications (anaemia 35.2% vs. 0. 9%; OR 68.79, 95% CI 14.28-452.19, p <0.01). Mother to child transmission of HIV was recorded in only 3(1.1%) babies among the subjects. Commencement of HAART before pregnancy appears to improve pregnancy outcomes in HIV positive women.
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