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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 3/2017

01-03-2017 | Maternal-Fetal Medicine

Pregnancy outcomes in HIV-positive women: a retrospective cohort study

Authors: Kholoud Arab, Andrea R. Spence, Nicholas Czuzoj-Shulman, Haim A. Abenhaim

Published in: Archives of Gynecology and Obstetrics | Issue 3/2017

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Abstract

Purpose

In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women.

Methods

A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003–2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV. Multivariate logistic regression was used to estimate the adjusted effect of HIV status on obstetrical and neonatal outcomes.

Results

Among 7,772,999 births over the study period, 1997 were in HIV-positive women (an incidence of 25.7/100,000 births). HIV-infected patients had greater frequency of pre-existing diabetes and chronic hypertension, and use of cigarettes, drugs, and alcohol during pregnancy (p < 0.001). Upon adjustment for baseline characteristics, HIV-infected women had greater likelihood of antenatal complications: preterm premature rupture of membranes (OR 1.35, 95% CI 1.14–1.60) and urinary tract infections (OR 3.02, 95% CI 2.40–3.81). Delivery and postpartum complications were also increased among HIV-infected women: cesarean delivery (OR 3.06, 95% CI 2.79–3.36), postpartum sepsis (OR 8.05, 95% CI 5.44–11.90), venous thromboembolism (OR 2.21, 95% CI 1.46–3.33), blood transfusions (OR 3.67, 95% CI 3.01–4.49), postpartum infection (OR 3.00, 95% CI 2.37–3.80), and maternal mortality (OR 21.52, 95% CI 12.96–35.72). Neonates born to these mothers were at higher risk of prematurity and intrauterine growth restriction.

Conclusion

Pregnancy in HIV-infected women is associated with adverse maternal and newborn complications. Pregnant HIV-positive women should be followed in high-risk healthcare centers.
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Metadata
Title
Pregnancy outcomes in HIV-positive women: a retrospective cohort study
Authors
Kholoud Arab
Andrea R. Spence
Nicholas Czuzoj-Shulman
Haim A. Abenhaim
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4271-y

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