Maternal HIV status and pregnancy outcomes in northeastern Tanzania: a registry‐based study

Abstract

Objectives The proportion of women delivering with known HIV status in sub‐Saharan Africa is not well described. Risk of HIV transmission to newborns is a major concern, but there may also be increased risks for other adverse pregnancy outcomes. Design Hospital registry. Setting North East Tanzania (1999–2006). Population Singletons (n= 14 444). Methods Births were grouped by maternal HIV status and socio‐demographic factors predicting HIV status, and associations between status and pregnancy outcomes were studied. Main outcome measures Maternal HIV status, perinatal mortality, prematurity, small for gestational age (SGA), birthweight and low Apgar score. Results The proportion of mothers with known HIV status increased from 7% before 2001 to 78% after 2004. Single motherhood, rural residence, low maternal education, maternal and paternal farming and higher paternal age were associated with unknown HIV status. About 7.4% (95% CI 6.7–8.1%) of women were HIV infected, with increased likelihood of infection with higher gravidity, single motherhood, rural residence, maternal business or farming occupations and paternal tribe. Compared with HIV‐uninfected women, the untreated HIV‐infected women had a higher risk of SGA births (adjusted risk ratio [ARR] 1.6; 95% CI 1.1–2.4), preterm birth (ARR 1.8; 95% CI 1.1–2.7) and perinatal death (ARR 1.9; 95% CI 0.95–3.8). Women with unknown HIV status had moderately increased risks. Treated HIV‐infected women had a risk similar to that of the HIV‐uninfected women for all outcomes, except for low Apgar score. Conclusion HIV testing and infection were associated with socio‐demographic factors. Untreated HIV‐infected women had higher risks of adverse pregnancy outcomes, and risks were also increased for women with unknown HIV status. There is still a need to increase availability of HIV testing, education and adequate therapy for pregnant women.

Clinical and epidemiological profile and reproductive outcome in hiv-infected pregnant women assisted at a university hospital maternity in vitória, brazil

“…Spontaneous rupture of membranes above 4 hours could not be evaluated in this study precisely, which is a recognized factor associated with mother-to-child transmission of HIV, as well as the high viral load and prematurity (6) . The occurrence of preterm birth was higher than the reported in several studies of pregnant women infected with HIV (9,19,20) , which is the Brazilian average occurrence (21) and much higher than the 4.8% of the Live Birth Information System (SINASC) from Vitoria (22) , corresponding to a direct increase of 12.6% (Number Needed to Treat (NNT): 7.9, Simple ratio (SR): 3.6 and OR: 4.18 (95%CI 2.37-7.35)). These data indicate the need for preventive actions for the monitoring of pregnant women infected with HIV in order to reduce these events.…”

Perinatal outcome in hiv infected pregnant women at tertiary care hospital in north india: eleven years retrospective study

“…It is possible subclinical chorio-amnionitis may more common in HIV infected mothers and this could cause preterm labour and perinatal hypoxia 18,19 . Habib et al had also shown an association between maternal HIV status and preterm labour 8 . Preterm deliveries were 1.8% in study by Prameela et al 9 20 .…”

“…The risk of perinatal death in the HIV infected group was found to be 89% higher than that in the non-infected group (Habib N, 2008) 8 .…”

Establishing a Twin Registry in Guinea-Bissau

“…Yet the etiology of LBW is not the same in a high mortality country as Guinea-Bissau. Maternal HIV infection (Habib et al, 2008) and malaria (Guyatt & Snow, 2004) are risk factors for LBW, while socio-economic factors, nutrition, and access to health services likely also play a role. Hence, more studies are needed to explore the association between LBW and various disease phenotypes in Sub-Saharan Africa.…”