Comparable Pregnancy Outcomes for HIV-Uninfected and HIV-Infected Women on Antiretroviral Treatment in Kenya.

Abortion, Spontaneous Anti-Retroviral Agents / therapeutic use Female HIV Infections / complications Humans Infant, Newborn Kenya / epidemiology Pregnancy Pregnancy Complications / drug therapy Pregnancy Complications, Infectious / drug therapy Pregnancy Outcome / epidemiology Premature Birth / epidemiology

HIV antiretroviral therapy low birth weight pregnancy loss prematurity sub-Saharan Africa test and treat

Journal

The Journal of infectious diseases

ISSN: 1537-6613

Titre abrégé: J Infect Dis

Pays: United States

ID NLM: 0413675

Informations de publication

Date de publication:
04 09 2022

Historique:

received: 28 10 2021

accepted: 05 04 2022

pubmed: 12 4 2022

medline: 9 9 2022

entrez: 11 4 2022

Statut: ppublish

Résumé

The impact of human immunodeficiency virus (HIV) on pregnancy outcomes for women on antiretroviral therapy (ART) in sub-Saharan Africa remains unclear. Pregnant women in Kenya were enrolled in the second trimester and followed up to delivery. We estimated effects of treated HIV with 3 pregnancy outcomes: loss, premature birth, and low birth weight and factors associated with HIV-positive status. Of 2113 participants, 311 (15%) were HIV infected and on ART. Ninety-one of 1762 (5%) experienced a pregnancy loss, 169/1725 (10%) a premature birth (<37 weeks), and 74/1317 (6%) had a low-birth-weight newborn (<2500 g). There was no evidence of associations between treated HIV infection and pregnancy loss (adjusted relative risk [aRR], 1.19; 95% confidence interval [CI], .65-2.16; P = .57), prematurity (aRR, 1.09; 95% CI, .70-1.70; P = .69), and low birth weight (aRR, 1.36; 95% CI, .77-2.40; P = .27). Factors associated with an HIV-positive status included older age, food insecurity, lower education level, higher parity, lower gestation at first antenatal clinic, anemia, and syphilis. Women who were overweight or underweight were less likely to be HIV infected compared to those with normal weight. Currently treated HIV was not significantly associated with adverse pregnancy outcomes. HIV-infected women, however, had a higher prevalence of other factors associated with adverse pregnancy outcomes.

Sections du résumé

BACKGROUND

The impact of human immunodeficiency virus (HIV) on pregnancy outcomes for women on antiretroviral therapy (ART) in sub-Saharan Africa remains unclear.

METHODS

Pregnant women in Kenya were enrolled in the second trimester and followed up to delivery. We estimated effects of treated HIV with 3 pregnancy outcomes: loss, premature birth, and low birth weight and factors associated with HIV-positive status.

RESULTS

Of 2113 participants, 311 (15%) were HIV infected and on ART. Ninety-one of 1762 (5%) experienced a pregnancy loss, 169/1725 (10%) a premature birth (<37 weeks), and 74/1317 (6%) had a low-birth-weight newborn (<2500 g). There was no evidence of associations between treated HIV infection and pregnancy loss (adjusted relative risk [aRR], 1.19; 95% confidence interval [CI], .65-2.16; P = .57), prematurity (aRR, 1.09; 95% CI, .70-1.70; P = .69), and low birth weight (aRR, 1.36; 95% CI, .77-2.40; P = .27). Factors associated with an HIV-positive status included older age, food insecurity, lower education level, higher parity, lower gestation at first antenatal clinic, anemia, and syphilis. Women who were overweight or underweight were less likely to be HIV infected compared to those with normal weight.

CONCLUSIONS

Currently treated HIV was not significantly associated with adverse pregnancy outcomes. HIV-infected women, however, had a higher prevalence of other factors associated with adverse pregnancy outcomes.

Identifiants

DOI: 10.1093/infdis/jiac128 PMID: 35403695 PMC: PMC10155227

pubmed: 35403695

pii: 6566248

doi: 10.1093/infdis/jiac128

pmc: PMC10155227

mid: NIHMS1893775

doi:

Substances chimiques

Anti-Retroviral Agents 0

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

Pagination

678-686

Subventions

Organisme : Intramural CDC HHS

ID : CC999999

Pays : United States

Organisme : ACL HHS

ID : U01GH002143

Pays : United States

Informations de copyright

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