Absence of Antenatal Care and Antiretroviral Therapy Associated with Preterm Delivery in Women with HIV: An 11-Year Retrospective Cohort in South Carolina.

Abstract

Our primary aim was to determine if combined antiretroviral therapy (cART) increased the risk of poor infant outcomes among women with HIV. Maternal antiretroviral regimens were classified as mono-(mARV), dual (dARV), cART, and no ARV. Differences in dichotomous outcomes were compared using χ2 tests and continuous outcomes were compared using Kruskal-Wallis tests. Predictors of preterm delivery (PTD), low birth weight, and perinatal HIV infection were determined using logistic regression. During the 11-year study period, 643 mother-baby pairs with HIV exposure were eligible for analysis. Non-Hispanic, Black women were more likely to report mARV or no ARV use (p=.03). Women not taking ARVs were more likely to have PTD (p=.01). Prenatal care was associated with a reduction in PTD [aOR 0.12 (95% CI 0.03-0.5)] and perinatal HIV infection [aOR 0.1 (95% CI 0.01-0.7)]. Maternal cART and race were not associated with PTD. Rather, absence of prenatal care and lack of ARV use during pregnancy increased the risk of PTD and perinatal HIV infection.