Adverse pregnancy outcomes in HIV positive women. A study from a District General Hospital in the UK

Abstract

Results Mean age was 34 yrs ranging from 20-43 yrs. Majority (91%) were of African origin; 67% had HIV subtype C; 26% resistant to one or more class of HIV drugs; 55% had a nadir CD4 fewer than 350; 44% diagnosed at an antenatal setting and 62% were planned pregnancies. Prior to the current pregnancy, these women had 121 children: 5% of the children have HIV and 33% not tested for HIV. None of the children born during the study period were infected with HIV; there were 3 sets of twins; one still birth and one child died soon after birth. Around 46% were on anti retroviral therapy (ART) during conception, 6% had miscarriage and 16% had emergency caesarean section. 38% of the women experienced an obstetric complication, premature labour 9%; premature rupture of membranes and gestational diabetes both accounted to 4% whilst 3% had post partum haemorrhage. On ART during conception and late HIV diagnosis, nadir CD4, less than 350 cells were significantly associated (P< 0.05) with having a foetal complication such as prematurity 8%, low birth weight 7% or having a foetal abnormality 2.3%. More analysis is awaited as to drug exposure and adverse outcomes.