Obstetric and perinatal outcome in HIV positive women receiving HAART in urban Nigeria

Olagbuji, Biodun Nelson; Ezeanochie, Michael; Ande, Adedapo; Oboro, VO

doi:10.1007/s00404-009-1186-x

Cited by 43 publications

(39 citation statements)

References 13 publications

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“…[8,[12][13][14] With regards to LBW in our study, the rates were similar: 17.1% and 20.7% in the pre-and post-conception groups, respectively. This result is in line with other studies conducted in Brazil and the USA, [11,15] both of which did not find any association between birth weight and the use of ART.…”

Section: Discussionsupporting

confidence: 60%

“…However, contrasting results from Europe, Cote d'Ivore and Nigeria indicated higher rates of LBW among women receiving ART. [8,13,14] …”

Section: Discussionmentioning

confidence: 99%

“…In a Cote d'Ivoire study [13] it was highlighted that ART in pregnant women with advanced HIV disease substantially reduced mother-to-child transmission, but was associated with low birth weight (LBW). A matched case-control study conducted in Nigeria [14] found that HIV-positive women were significantly more likely to have intrauterine growth restriction, preterm labour and LBW babies than HIV-negative women.…”

mentioning

confidence: 99%

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Impact of antiretroviral therapy on pregnancy outcomes

Aniji

Towobola²,

Hoque³

et al. 2013

South. Afr. j. HIV med.

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Background. The majority of HIV-positive women in South Africa are of reproductive age, and pregnancies among women using antiretroviral therapy (ART) are common. However, there are mixed data regarding the impact of ART on pregnancy outcomes. Objective. To examine the impact of ART on pregnancy outcome according to the timing of initiation of treatment. Methods. A retrospective cohort study was conducted among women delivering at a tertiary hospital from 1 October 2008 to 31 March 2009. Results. A total of 245 mothers were receiving ART: 76 mothers (31%) started ART pre-conception and 169 mothers (69%) started ART after the first trimester. No significant differences were observed in the rates of preterm delivery and low birth weight (LBW) between the pre-and post-conception groups (21% v. 24% and 21% v. 25%, respectively). Conclusion. In this cohort of women receiving ART in pregnancy, timing of ART initiation did not have any adverse effect on the measured pregnancy outcomes such as preterm delivery and LBW.

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Section: Discussionsupporting

confidence: 60%

“…However, contrasting results from Europe, Cote d'Ivore and Nigeria indicated higher rates of LBW among women receiving ART. [8,13,14] …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of antiretroviral therapy on pregnancy outcomes

Aniji

Towobola²,

Hoque³

et al. 2013

South. Afr. j. HIV med.

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“…Since preterm birth is associated with increased rate of MTCT of HIV, drugs of abuse may increase MTCT of HIV by inducing preterm birth. Recent reports suggest that use of HAART itself may increase the risk of preterm birth (Haeri et al 2009;Boer et al 2009;Olagbuji et al 2009). Thus, HAART and drugs of abuse may adversely impact MTCT rate in an additive or synergistic manner.…”

Section: Drugs Of Abuse Can Induce Preterm Birthmentioning

confidence: 97%

Mother-to-Child Transmission (MTCT) of HIV and Drugs of Abuse in Post-Highly Active Antiretroviral Therapy (HAART) Era

Purohit

Rapaka

Shurtleff

2010

J Neuroimmune Pharmacol

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In the pre-highly active antiretroviral therapy (HAART) era, prenatal "vertical" mother-to-child transmission (MTCT) of HIV was about 25% and exposure of pregnant mothers to drugs of abuse (illicit drugs and tobacco smoking) was a significant contributory factor of MTCT. However, with the introduction of HAART, the rate of MTCT of HIV has decreased to less that 2%. But, it is estimated that currently about 5.1% of pregnant women use illicit drugs and 16.4% smoke tobacco. The residual prevalence of MTCT is of concern and may be related to this continued prevalence of substance use among pregnant mothers. In this report, we review and present evidence that supports the hypothesis that drugs of abuse do have the potential to increase MTCT of HIV in the presence of HAART. Exposure to drugs of abuse during pregnancy may increase MTCT of HIV through a variety of mechanisms that are addressed in detail including possible damage to the placenta, induction of preterm birth, and increasing maternal plasma viral load though a variety of putative mechanisms such as: (a) promoting HIV replication in monocyte/macrophages; (b) increasing the expression of CCR5 receptors; (c) decreasing the expression of CCR5 receptor ligands; (d) increasing the expression of CXCR4 receptors; (e) increasing the expression of DC-SIGN; (f) impairing the efficacy of HAART through drug-drug interaction; and (g) promoting HIV mutation and replication through non-adherence to HAART.

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“…This is a likely way of counselling women with advanced HIV disease, especially multifarious women on the detrimental impact of HIV co-infection in pregnancy, as studies have documented both adverse maternal and perinatal outcome in HIVinfected women. 22,23 These maternal death audit, highlight the need to extend comprehensive PMTCT programme to primary health care centres and operational links between all levels of health care and antiretroviral therapy programmes including HIV testing and counselling ,the gateway to comprehensive PMTCT program, as rare encounter with higher level of health care are likely among women in indigenous population .…”

mentioning

confidence: 99%

HIV-AIDS related maternal mortality in Benin city, Nigeria

Onakewhor

Olagbuji²,

Ande³

et al. 2011

Ghana Medical Journal

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SUMMARYObjective: To determine the causes and characteristics of maternal deaths in HIV-infected women. Design: A retrospective study of maternal deaths in a cohort of HIV-infected women. Setting: A facility-based maternal death review using case records and mortality summaries. Methods: Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4-year period. Causes and circumstances surrounding each maternal death were identified. Result: One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancyrelated sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia. Conclusion: HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections.

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Obstetric and perinatal outcome in HIV positive women receiving HAART in urban Nigeria

Abstract: Anaemia in pregnancy, intrauterine growth restriction, preterm labour and birth weight less than 2,500 g are important complications among HIV positive pregnant women. This information is vital for strategic antenatal care planning to improve obstetric and perinatal outcome in these women.

Cited by 43 publications

References 13 publications

Impact of antiretroviral therapy on pregnancy outcomes

Impact of antiretroviral therapy on pregnancy outcomes

Mother-to-Child Transmission (MTCT) of HIV and Drugs of Abuse in Post-Highly Active Antiretroviral Therapy (HAART) Era

HIV-AIDS related maternal mortality in Benin city, Nigeria

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