AIDS in pregnancy among Indian tribal women

Abstract

In February 1992 71 tribal women from Manipur India with AIDS matched for age parity CD4 lymphocyte counts and demographic characteristics were recruited into a prospective study. 32 women were 8-10 weeks pregnant while the remainder were not pregnant. Both groups were closely studied until February 1996. Pneumocystis carinii pneumonia followed by miliary tuberculosis and wasting disease were the most common AIDS-defining illnesses and causes of maternal death in both groups. 28 women died as a direct result of AIDS-defining illness 18 of whom were pregnant. Three of these 18 deaths occurred within 14 weeks of an uneventful first trimester medical termination of pregnancy; 13 died undelivered at 30-34 weeks gestation and two died within 3 weeks of delivery. 14 women delivered vaginally 14 preterm infants at 28-35 weeks gestation. 11 of these infants died within 6 weeks of which nine deaths were a direct result of prematurity and clinical diagnosis of AIDS-defining illness. The mean survival time was 9.72 months for the pregnant and 22.6 months for the nonpregnant mothers respectively. These study outcomes indicate that in AIDS-infected pregnant women pregnancy had a significantly adverse effect upon both maternal and obstetrical outcome. Also there was clinical and immunological deterioration with acceleration of material disease process resulting in a very high rate of prematurity maternal mortality and a significant decrease in survival time compared to nonpregnant women.