HIV serostatus, viral load, and midtrimester cervical length in a Zambian prenatal cohort

Abstract

Objective To evaluate whether maternal HIV serostatus and plasma viral load (VL) are associated with midtrimester cervical length (CL). Methods The Zambian Preterm Birth Prevention Study (ZAPPS) is an ongoing prospective cohort that began enrolling in Lusaka in August 2015. Pregnant women undergo ultrasound to determine gestational age and return for CL measurement at 16–28 weeks. We evaluated crude and adjusted associations between dichotomous indicators and short cervix (≤2.5 cm) via logistic regression, and between VL and CL as a continuous variable via linear regression. Results This analysis includes 1171 women enrolled between August 2015 and September 2017. Of 294 (25.1%) HIV‐positive women, 275 (93.5%) had viral load performed close to CL measurement; of these, 148 (53.8%) had undetectable virus. Median CL was 3.6 cm (IQR 3.5–4.0) and was similar in HIV‐infected (3.7 cm, IQR 3.5–4.0) versus uninfected (3.6 cm, IQR 3.5–4.0) participants (P=0.273). The odds of short CL were similar by HIV serostatus (OR 0.64; P=0.298) and detectable VL among those infected (OR 2.37, P=0.323). We observed no association between log VL and CL via linear regression (–0.12 cm; P=0.732). Conclusion We found no evidence of association between HIV infection and short CL.

Mid-trimester cervical length not associated with HIV status among pregnant women in Botswana

“…[36] In a recent Zambian cohort, median cervical length was 36mm. [37] Further research is needed to understand whether mid-trimester cervical length differs in distinct settings around the world and whether this has implications for the incidence of PTB.…”