Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study
Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and deliv...
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The Journal of Infection in Developing Countries
2020-08-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/11745 |
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| author | Tung-Che Hung Li-Cheng Lu Mei-Hui Lin Yu-Chia Hu Chien-Yu Cheng Shu-Hsing Cheng Chien-Yu Lee |
| author_facet | Tung-Che Hung Li-Cheng Lu Mei-Hui Lin Yu-Chia Hu Chien-Yu Cheng Shu-Hsing Cheng Chien-Yu Lee |
| author_sort | Tung-Che Hung |
| collection | DOAJ |
| description |
Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care.
Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well.
Results: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV.
Conclusions: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.
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| format | Article |
| id | doaj-art-c7bb7e23bfc54d19a42d47724645cb91 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-c7bb7e23bfc54d19a42d47724645cb912025-08-20T02:27:07ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-08-01140810.3855/jidc.11745Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control studyTung-Che Hung0Li-Cheng Lu1Mei-Hui Lin2Yu-Chia Hu3Chien-Yu Cheng4Shu-Hsing Cheng5Chien-Yu Lee6Department of Infectious Diseases, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Gynecology and Obstetrics, Taoyuan General Hospital, Ministry of Health and Welfare, TaoyuanDepartment of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, TaiwanDepartment of Gynecology and Obstetrics, Taoyuan General Hospital, Ministry of Health and Welfare, TaoyuanDepartment of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, TaiwanDepartment of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, TaiwanDepartment of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well. Results: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV. Conclusions: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied. https://jidc.org/index.php/journal/article/view/11745pregnancyfetusHIVAIDSantiretroviral therapy |
| spellingShingle | Tung-Che Hung Li-Cheng Lu Mei-Hui Lin Yu-Chia Hu Chien-Yu Cheng Shu-Hsing Cheng Chien-Yu Lee Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study Journal of Infection in Developing Countries pregnancy fetus HIV AIDS antiretroviral therapy |
| title | Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study |
| title_full | Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study |
| title_fullStr | Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study |
| title_full_unstemmed | Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study |
| title_short | Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study |
| title_sort | characteristics of hiv positive pregnant women and hiv and antiretroviral therapy exposed fetuses a case control study |
| topic | pregnancy fetus HIV AIDS antiretroviral therapy |
| url | https://jidc.org/index.php/journal/article/view/11745 |
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