BJOG: An International Journal of Obstetrics & Gynaecology

Original Article

Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: a cohort study

Corresponding Author

R Kreitchmann

Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

Correspondence: Dr R Kreitchmann, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Av. Lucas de Oliveira 1937/202, Porto Alegre, Rio Grande do Sul 90460-001, Brazil. Email [email protected]Search for more papers by this author

SX Li,

SX Li

Westat, Rockville, MD, USA

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VH Melo,

VH Melo

Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

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D Fernandes Coelho,

D Fernandes Coelho

Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

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DH Watts,

DH Watts

Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, USA

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E Joao,

E Joao

Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil

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CM Coutinho,

CM Coutinho

Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil

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JO Alarcon,

JO Alarcon

Tropical Medicine Institute Daniel A. Carrion, University of San Marcos, Lima, Peru

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GK Siberry,

GK Siberry

Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, USA

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R Kreitchmann,

Corresponding Author

R Kreitchmann

Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

SX Li,

SX Li

Westat, Rockville, MD, USA

Search for more papers by this author

VH Melo,

VH Melo

Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

Search for more papers by this author

D Fernandes Coelho,

D Fernandes Coelho

Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

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DH Watts,

DH Watts

Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, USA

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E Joao,

E Joao

Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil

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CM Coutinho,

CM Coutinho

Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil

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JO Alarcon,

JO Alarcon

Tropical Medicine Institute Daniel A. Carrion, University of San Marcos, Lima, Peru

Search for more papers by this author

GK Siberry,

GK Siberry

Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, USA

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First published: 07 March 2014

https://doi.org/10.1111/1471-0528.12680

Citations: 27

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Abstract

Objective

To examine maternal characteristics associated with adverse pregnancy outcomes among women infected with HIV.

Design

Prospective cohort study.

Setting

Multiple sites in Latin America and the Caribbean.

Population

Women infected with HIV enrolled in the Perinatal (2002–2007) and the Longitudinal Study in Latin American Countries (LILAC; 2008–2012) studies of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).

Methods

Frequencies of adverse pregnancy outcomes assessed among pregnancies. Risk factors investigated by logistic regression analysis.

Main outcome measures

Adverse pregnancy outcomes, including preterm delivery (PT), low birthweight (LBW), small for gestational age (SGA), stillbirth (SB), and neonatal death.

Results

Among 1512 women, 1.9% (95% confidence interval, 95% CI, 1.3–2.7) of singleton pregnancies resulted in a stillbirth and 32.9% (95% CI 30.6–35.4) had at least one adverse pregnancy outcome. Of 1483 singleton live births, 19.8% (95% CI 17.8–21.9) were PT, 14.2% (95% CI 12.5–16.1) were LBW, 12.6% (95% CI 10.9–14.4) were SGA, and 0.4% (95% CI 0.2–0.9) of infants died within 28 days of birth. Multivariable logistic regression modelling indicated that the following risk factors increased the probability of having one or more adverse pregnancy outcomes: lower maternal body mass index at delivery (odds ratio, OR, 2.2; 95% CI 1.4–3.5), hospitalisation during pregnancy (OR 3.3; 95% CI 2.0–5.3), hypertension during pregnancy (OR 2.7; 95% CI 1.5–4.8), antiretroviral use at conception (OR 1.4; 95% CI 1.0–1.9), and tobacco use during pregnancy (OR 1.7; 95% CI 1.3–2.2). The results of fitting multivariable logistic regression models for PT, LBW, SGA, and SB are also reported.

Conclusions

Women infected with HIV had a relatively high occurrence of adverse pregnancy outcomes, and some maternal risk factors were associated with these adverse pregnancy outcomes. Interventions targeting modifiable risk factors should be evaluated further.

Supporting Information

References

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Citing Literature

Volume121, Issue12

November 2014

Pages 1501-1508

Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: a cohort study

Abstract

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusions

Supporting Information

References

Citing Literature

References

Information

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Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: a cohort study

Abstract

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusions

Supporting Information

References

Citing Literature

References

Related

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