HIV-positive Pregnant Women Research Articles

Prevalence of hazardous alcohol consumption and associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia: a multicentred cross-sectional study

BackgroundAlcohol is a major public health problem in pregnant women due to its harmful effects on pregnancy and adverse birth outcomes. Therefore, assessing the prevalence and the factors associated with...

Ocular and Adnexal Diseases in Human Immunodeficiency Virus-Infected Pregnant Women Attending HIV Clinics in Ibadan, Nigeria

Abstract Background: Human immunodeficiency virus (HIV) is a lentivirus. It is transmitted through sexual intercourse, shared intravenous drugs, contaminated needle use, blood transfusion, and mother-to-child transmission. Of the patients with HIV, 50%–75% have ocular manifestations and this may be the primary presentation. This study was carried out in two prevention of mother-to-child transmission (PMTCT)/HIV clinics. The aim was to determine the incidence, patterns of presentation, and determinants of ocular and adnexal diseases in HIV-positive pregnant women attending HIV clinics to develop an eye care protocol for them. Materials and Methods: The study was a cross-sectional study of HIV-positive pregnant women attending the PMTCT/HIV Clinics at University College Hospital and Adeoyo Maternity Teaching Hospital, Ibadan. Patients were interviewed using a structured questionnaire. Blood samples were taken for CD4+ count and viral load. The stage of the disease, type of antiretroviral therapy (ART), and the interval between HIV diagnosis and commencement of ART were recorded. Comprehensive ocular examination, which included visual acuity check unaided and with pinhole, lid, anterior segment examination with slit lamp and posterior segment examination with dilated binocular indirect ophthalmoscopy, was conducted. Statistical Package for Social Sciences version 23 was used to analyse the data. Results: A total of 153 pregnant women aged 23–42 years (mean, 33.5; standard deviation, ±5.6) were recruited. One hundred and fifteen (75.2%) of them were married in a monogamous setting. Multiple sexual partners (48.4%; n = 74—some women married in monogamous settings at the time of recruitment for this study had multiple sexual partners in the past) and the use of unsterilised objects (46.4%; n = 71) were major high-risk behaviours. Ocular and adnexal diseases were found in 81 (53%) participants. HIV-related ocular and adnexal diseases were found in 16 (10%) participants. Of the 16 HIV-related diseases, optic atrophy was found in seven (43.8%), presumed toxoplasmosis in three (18.7%), presumed cytomegalovirus retinitis in three (18.7%) lid warts in two (12.5%), and conjunctival microangiopathy in one (6.3%) participant. The association between HIV- related ocular and adnexal diseases and gestational age, CD4+ count, viral load and type of ART was not statistically significant. Conclusion: The few HIV-related findings in this study could be a result of the improved CD+ count/low viral load of most of the recruited participants. Ensuring that patients attending PMTCT/HIV clinic have at least one ocular examination during pregnancy by collaborating with eyecare professionals could ensure prompt detection and treatment of eye diseases, to improve the quality of life of HIV-positive pregnant women.

Factors that determine the level of non-adherence to HAART among HIV-positive pregnant women in Kaduna State

Despite a decreased trend in the global HIV burden, up to 46% of fresh infections were reported in women and girls in 2022, with sub-Saharan Africa accounting for 70% of cases. One of the reasons HIV remains a major public health threat in Nigeria, the most populous country in Africa, is pregnant women's non-adherence to ART, which can lead to drug resistance resulting in the transmission of the virus to the unborn child. This study was aimed at determining the levels of non-adherence and identifying factors determining non-adherence to ART among HIV-positive pregnant women in Kaduna state. It was a cross-sectional study using a three-stage sampling technique. It involved 318 HIV-positive pregnant women attending ANC in nine selected hospitals. Electronic questionnaires were administered over 10 weeks. Non-adherence was assessed using four validated techniques. Pill count calculation was used as an indicator of non-adherence for further analysis on account of its documented correlation with better adherence. Bivariate and multivariate analyses were done with Microsoft Excel and Epi Info software. Levels of non-adherence ranged from 5.7% (3-day recall) to 28.6% (7-day recall) to 6.6% (Visual Analogue Scale) to 13.8% (Pill Count). Of all the factors affecting non-adherence (pill count), having a negative attitude toward ART was significantly associated with non-adherence. The level of non-adherence, a function of the assessment method, is lower than in most similar studies. We propose that qualified staff should enhance effective ongoing triage-based interventions using a graded baseline assessment to ensure that all HIV-pregnant women on HAART attain optimal adherence.

Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women.

Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women.

Evaluation of the prevalence and risk factors of perinatal depression among women living with HIV in the Amhara Region, Northwest Ethiopia

IntroductionDepressive disorder is a common mental health issue among perinatal mothers living with HIV, potentially leading to significant despair and anxiety. This condition can hinder maternal-infant bonding and undermine efforts to prevent mother-to-child transmission of HIV. Despite its importance, little is known about the factors associated with depression in this population. Main objectiveThis study aimed to evaluate the prevalence and risk factors of perinatal depression among women living with HIV in the Amhara region, Northwest Ethiopia, in 2022. MethodsAn institutional-based cross-sectional study was conducted among 399 HIV-positive pregnant and postpartum women, both with follow-up and newly diagnosed cases, who attended PMTCT services in the East Gojjam Zone Public Hospitals from May 28 to July 12, 2022. Participants were selected using a simple random sampling technique. Data were collected through direct interviews and document reviews. The Edinburgh Perinatal Depression Scale was used to assess perinatal depression which demonstrated high internal reliability (Cronbach's alpha of 0.93). Data were cleaned and analyzed using Epi-data version 3.1 and SPSS version 25. Binary logistic regression models were used to identify variables associated with perinatal depression, with statistical significance set at p < 0.05. ResultsOut of 399 eligible women, 394 participated, yielding a response rate of 98.7 %. The prevalence of perinatal depression among these women was 34.3 % (95 % CI: 29.6–39.4). Factors significantly associated with perinatal depression included intimate partner violence (AOR = 4.24, 95 % CI: 2.507–7.168), internalized stigma (AOR = 4.93, 95 % CI: 2.912–9.560), poor social support (AOR = 4.0, 95 % CI: 1.693–9.560), and poor adherence to antiretroviral therapy (AOR = 3.65, 95 % CI: 1.774–7.519). ConclusionApproximately one-third of perinatal women living with HIV experienced depression. Key factors contributing to this included intimate partner violence, internalized stigma, low social support, and poor adherence to antiretroviral therapy. Interventions should focus on enhancing social support, empowering women, counseling on drug adherence, and screening for depression among perinatal women living with HIV.

Assessment of the Knowledge, Attitude and Practice (KAP) of PMTCT among Healthcare Providers at the University of Ghana Legon

One of the leading causes of morbidity and mortality among communicable diseases is acquired immunodeficiency syndrome (AIDS). A vulnerable group in this setting is HIV exposed infants, (born to women living with HIV). The magnitude of the pandemic of HIV infection in developing countries is such that multiple approaches are required to show its spread and alleviate the burden on the health sector and society in general. Every woman of childbearing age needs to be aware of HIV infection, the risks of Mother-to-Child Transmission and the services available to reduce such risks. Considering these, this study assessed the knowledge, attitude and practice of Prevention of mother-to-child transmission (PMTCT) among healthcare providers at the University of Ghana Legon. A descriptive cross-sectional design was used in this study. The minimum sample size for this study was calculated using the single proportion population formula by Fisher (1978): The study area was the University of Ghana Hospital Legon. The collected data was exported into STATA version 16.0 for cleaning and analysis. Descriptive analysis, such as simple frequencies, percentages, means, and standard deviations, were used to summarize the data. Findings were presented in tables and graphs. Generally, the data accumulated from the research on the knowledge, attitude and practice of PMTCT among healthcare workers indicate that there is unsatisfactory knowledge and practice. In this study, no participants had a total good score above 85%. The relationship between gender, ward and knowledge was investigated using a chi-square. The p-value was higher than the alpha-value, indicating acceptance of the null hypothesis (p-value = 0.79 and 0.053, alpha value = 0.05). Sixteen (16) of the respondents, representing 17.6%, said HIV positive pregnant women should be managed like any other pregnant woman in Labour. The majority of the respondents (56) said at the first week of pregnancy, while only (2) said at week 28. However, their attitude was satisfactory. It must be noted that without further training and an increase in staffing levels, the quality and accessibility of PMTCT will be severely affected. It is therefore recommended that there should be continuous and pre-service training on PMTCT. All new medical officers, midwives and nurses should undergo PMTCT training, and those who are already in service should take refresher courses on new and updated guidelines.

Projected impact of fast-tracking of anti-retroviral treatment coverage on vertical transmission of HIV in India.

One of the five high-level goals under Phase V of the National AIDS and STD Control Programme (NACP) of the Government of India is the elimination of vertical transmission of HIV. In this paper, we estimate the potential impact of maintaining and enhancing the anti-retroviral treatment under the NACP in terms of averting new infections and vertical transmission rates vis-à-vis no intervention scenario. We used India's HIV Estimates 2022 models to create treatment coverage scenarios of no interventions, status quo, business as usual, on-track and fast-track scenarios from 2023 to 2030. Our analysis indicates that fast-tracking scale-up of treatment services would avert almost 41000 child infections from 2023 to 2030 leading to a vertical transmission rate of around 7.70% in 2030 vis-a-vis no interventions scenario. Higher and sustained ART coverage would not only take the country closer to the elimination goals but would also prevent thousands of vertical transmissions, thus bringing a lot of benefits to HIV-positive pregnant women and their families. Supported by efforts for the prevention of new infections in the general population, India is on track for the attainment of elimination of vertical transmission of HIV by 2030.

Respiratory Syncytial Virus among People Living with HIV: Is There a Case for Rolling Out Prophylaxis? A Viewpoint Based on a Systematic Review.

Respiratory Syncytial Virus (RSV) is responsible for a considerable burden of respiratory disease among children and older adults. Several prophylactic strategies have recently been introduced. We review the available evidence on the interplay between RSV infection and HIV, looking at the specific role of RSV prophylactic strategies in individuals affected by or exposed to HIV. We conducted a systematic review on the association between HIV infection and RSV incidence and severity. We searched in PubMed/MEDLINE for clinical epidemiological studies covering outcomes such as RSV-associated illness, severity, and mortality in individuals affected by or exposed to HIV. A total of 36 studies met the inclusion criteria and were included, the majority conducted in sub-Saharan Africa. There was no compelling evidence suggesting a higher incidence of RSV illness among HIV-infected people. A higher risk of severe disease was consistent among both HIV-positive and HIV-exposed but uninfected (HEU) children. Case fatality rates were also higher for these groups. Evidence on a differing risk among adults was scarce. HIV-positive pregnant women should be given priority for recently approved RSV vaccination, for protection of their newborns. HIV-infected and HEU infants should be considered risk groups for nirsevimab prophylaxis in their first year of life and possibly beyond.

Red Cell Distribution Width and its Association with Maternal Mortality in HIV-Infected Pregnancy

Red Cell Distribution Width (RDW), a measure of the variability in red blood cell size, has gained attention for its role in diagnosing and predicting outcomes in various medical conditions. In the context of HIV-infected pregnancies, RDW may serve as a significant marker for assessing maternal health and predicting complications. This review explores the association between RDW and maternal mortality in HIV-positive pregnant women, highlighting how fluctuations in RDW can indicate underlying issues such as anemia, inflammation, and the effects of antiretroviral therapy (ART). Elevated RDW levels may correlate with increased risk of adverse outcomes, making it a potentially valuable tool in managing HIV-infected pregnancies. HIV infection complicates pregnancy by increasing the risk of adverse outcomes, including preeclampsia, gestational diabetes, and anemia, all of which can contribute to maternal mortality. RDW, by reflecting red blood cell variability, offers insights into these complications and the overall impact of HIV on maternal health. ART, crucial for managing HIV, can also influence RDW levels, as some regimens may affect red blood cell production and contribute to anemia. Monitoring RDW in conjunction with ART and other clinical parameters can enhance the detection of complications and improve management strategies.

Guidance for triangulating data and estimates of HIV prevalence among pregnant women and coverage of PMTCT using the Spectrum AIDS Impact Module.

Most countries use the Spectrum AIDS Impact Module (Spectrum-AIM), antenatal care routine HIV testing, and antiretroviral treatment data to estimate HIV prevalence among pregnant women. Non-representative programme data may lead to inaccurate estimates HIV prevalence and treatment coverage for pregnant women. 154 countries and subnational locations across 126 countries. Using 2023 UNAIDS HIV estimates, we calculated three ratios: (1) HIV prevalence among pregnant women to all women 15-49y (prevalence), (2) ART coverage before pregnancy to women 15-49y ART coverage (ART pre-pregnancy), and (3) ART coverage at delivery to women 15-49y ART coverage (PMTCT coverage). We developed an algorithm to identify and adjust inconsistent results within regional ranges in Spectrum-AIM, illustrated using Burkina Faso's estimates. In 2022, the mean regional ratio of prevalence among pregnant women to all women ranged from 0.68 to 0.95. ART coverage pre-pregnancy ranged by region from 0.40 to 1.22 times ART coverage among all women. Mean regional PMTCT coverage ratios ranged from 0.85 to 1.51. The prevalence ratio in Burkina Faso was 1.59, above the typical range 0.62-1.04 in western and central Africa. Antenatal clinics reported more PMTCT recipients than estimated HIV-positive pregnant women from 2015 to 2019. We adjusted inputted PMTCT programme data to enable consistency of HIV prevalence among pregnant women from programmatic routine HIV testing at antenatal clinics with values typical for Western and central Africa. These ratios offer Spectrum-AIM users a tool to gauge the consistency of their HIV prevalence and treatment coverage estimates among pregnant women with other countries in the region.

Eosinophilic Changes in Peripheral Blood during Pregnancy in HIV-Positive Mothers

Eosinophils are critical components of the immune system, involved in allergic reactions, defense against parasitic infections, and modulation of immune responses. During pregnancy, the immune system undergoes significant adaptations, leading to changes in eosinophil dynamics that are essential for maintaining maternal-fetal tolerance. In HIV-positive mothers, these alterations may be further influenced by the immune dysregulation associated with HIV infection, resulting in complex eosinophilic changes in peripheral blood. This review explores the impact of pregnancy and HIV on eosinophil levels, examining how these changes can affect maternal and fetal health. Altered eosinophil dynamics during pregnancy in HIV-positive women have important implications for pregnancy outcomes. Eosinophils play a role in tissue remodeling and the immune response at the maternal-fetal interface, which is crucial for a successful pregnancy. Dysregulation of eosinophil function may lead to increased risks of complications such as gestational hypertension, preterm labor, and vertical transmission of HIV.

Protocol of a cost-effectiveness analysis of a combined intervention for depression and parenting compared with enhanced standard of care for perinatally depressed, HIV-positive women and their infants in rural South Africa

IntroductionPoverty, HIV and perinatal depression represent a triple threat to public health in sub-Saharan Africa because of their combined negative effects on parenting and child development. In the resource-constrained context...

Clinical, pharmacological, and qualitative characterization of drug-drug interactions in pregnant women initiating HIV therapy in Sub-Saharan Africa.

We investigated the impact of Drug-Drug Interactions (DDIs) on virologic control among HIV-positive pregnant women initiating antiretroviral therapy while identifying drivers for Traditional Medicine (TM) use and exploring the nature and extent of TM-related DDIs. Employing a three-pronged approach, we examined DDIs arising from comedication, including TM, in ART. The DolPHIN-2 trial (NCT03249181) randomized 268 HIV-positive pregnant women in Uganda and South Africa to dolutegravir (DTG)-based (135) or efavirenz-based (133) regimens while systematically recording comedications and screening for DDIs. We used Cox regression models to compare time-to-virologic control between participants with and without DDIs. We conducted in-depth interviews and focus group discussions among 37 and 67 women with and without HIV, respectively, to explore reasons for TM use during pregnancy. Additionally, in-vitro and in-vivo studies evaluated the composition and impact of clay-based TM, mumbwa, on DTG plasma exposure. The baseline prevalence of DDIs was 67.2%, with TM use prevalent in 34% of participants, with mumbwa being the most frequent (76%, 69/91). There was no difference in virologic response between participants with and without DDIs. Fetal health and cultural norms were among the reasons cited for TM use. Analysis of mumbwa rods confirmed significant amounts of aluminium (8.4%-13.9%) and iron (4%-6%). In Balb-C mice, coadministration of mumbwa led to a reduction in DTG exposure observed in the AUC0-24 (-21%; P = 0.0271) and C24 (-53%; P = 0.0028). The widespread use of clay-based TM may compromise HIV treatment, necessitating medication screening and counselling to manage DDIs in pregnant women.

Implications of HIV status disclosure

Disclosure of HIV status is critical for HIV prevention and control. However, although the benefits of HIV disclosure have received extensive documentation, the same cannot be said for its drawbacks. In the current study, we used a descriptive qualitative study design to highlight the implications of disclosure among 30 pregnant and postpartum women living with HIV in Uganda. We conducted a qualitative content analysis and found that healthcare professionals responded positively and supportively when HIV-positive pregnant and postpartum women disclosed their status, and that individuals who disclosed their status to their husbands but not to wider circles also experienced no mistreatment or discrimination. Contrarily, however, some husbands reacted unfavourably to their wife’s HIV-positive status when a larger audience was involved in the disclosure. In particular, we discovered that co-wives and in-laws promoted stigmatization, including violence, by husbands. The interaction between these HIV-positive women and their mothers also demonstrated both positive and negative implications. This counterintuitive attitude has the consequence of reducing the uptake of antiretroviral drugs. There is therefore a need for policies and initiatives that not only encourage disclosure to health professionals, spouses and a few close relatives or friends but prevent stigmatization, violence and other forms of abuse against HIV-positive women.

Gambaran Tingkat Pengetahuan Ibu Hamil Tentang Pencegahan Penularan HIV pada Anak (PPIA) di Puskesmas Putat Jaya Kota Surabaya

The proportion of HIV-positive pregnant women in Indonesia rises annually. Pregnant women’s HIV test results in Indonesia fall a little short of the target for 2022. Knowledge is one of the most important aspects of the prevention of mother-to-child transmission of HIV (PMTCT). The aim of this research is to determine the knowledge among pregnant women in Putat Jaya Community Health Care in Surabaya regarding the transmission of HIV from mothers to their children. Cross-sectional analysis is used in this descriptive study. There are 35 pregnant women who have responded. Mothers enrolled in trimesters 1, 2, and 3 who are getting antenatal care at Putat Jaya Community Health Care in Surabaya meet the inclusion criteria for this study. However, a mother with special needs is the sole requirement for this study. In September 2023, this study was carried out at Putat Jaya Community Health Care in Surabaya. The method for gathering samples is called purposive sampling. According to the findings, 77.1% were sufficiently aware of how to prevent HIV transmission from mother to child, followed by 14.3% who had high knowledge and 8.6% who had a lack of knowledge about the prevention of mother-to-child transmission (PMTCT) of HIV.

Association of angiogenic factors (placental growth factor and soluble FMS-like tyrosine kinase-1) in preeclamptic women of African ancestry comorbid with HIV infection.

Preeclampsia is a significant cause of maternal and fetal morbidity and mortality, particularly in low- and middle-income countries like South Africa. The aim of our study was to investigate the association between placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) in South African preeclamptic women of African ancestry, comorbid with HIV infection. The study population consisted of women attending a regional hospital in Durban, South Africa, stratified by pregnancy type (normotensive pregnant and preeclampsia) and HIV status. Preeclampsia was defined as new-onset hypertension and proteinuria. DNA was obtained from whole blood. The SNPs of interest were rs722503 in sFlt-1 and rs4903273 in PlGF. Our findings suggest that single nucleotide polymorphisms of rs722503 analysis show no significant associations between the genotypic frequencies of rs722503 variants and preeclampsia risk in either HIV-negative or HIV-positive groups of women of African ancestry. Similarly, the rs493273 polymorphism showed no significant association with preeclampsia risk in either HIV-negative or HIV-positive pregnant women. Additionally, comparisons of dominant, recessive, and over-dominant allele models did not reveal significant associations. These findings suggest that these genetic variants may not significantly contribute to preeclampsia development in this African ancestry population. However, significant differences were observed in the rs4903273 genotype frequencies between normotensive and preeclamptic women, regardless of HIV status, over dominant alleles AA + GG vs AG showed a significant difference [OR = 2.706; 95% Cl (1.199-5.979); adjusted p = 0.0234*], also in normotensive compared to EOPE (OR = 2.804; 95% Cl (1.151-6.89) p = 0.0326* and LOPE (OR = 2.601; 95% Cl (1.0310-6.539) p = 0.0492*), suggesting that they may be the potential role of this variant in preeclampsia susceptibility. The findings suggest that the rs722503 and rs493273 polymorphisms do not significantly contribute to preeclampsia susceptibility in HIV-negative or HIV-positive pregnant women. However, the rs4903273 genotype frequencies showed notable differences between normotensive and preeclamptic women, indicating a potential association with preeclampsia development in the African ancestry population irrespective of HIV status.

Incidence and Determinants of Adverse Neonatal Outcomes among HIV-Positive Pregnant Women: A Prospective Cohort Study at Regional Referral Hospitals in Uganda

HIV infection remains a significant global health challenge, affecting over 37.9 million people worldwide. Despite widespread access to antiretroviral therapy (ART), adverse neonatal outcomes are prevalent among pregnant women living with HIV. This prospective cohort study aimed to determine the incidence and factors associated with early adverse neonatal outcomes among HIV-positive mothers at Mubende and Fort Portal Regional Referral Hospitals (MRRH and FRRH), compared to HIV-negative mothers. The study excluded mothers with known risks for adverse neonatal outcomes. Neonates were monitored from birth to discharge within 7 days for adverse outcomes. Among 203 participants, 135 were HIV-negative and 68 were HIV-positive. Adverse neonatal outcomes were more frequent in the HIV-positive group (39.7% vs. 28.1%), although the difference was not statistically significant (P=0.096). Prematurity (20.6% vs. 8.1%, P=0.031) and low birth weight (25.0% vs. 12.6%, P=0.047) were significantly higher among HIV-positive mothers. Multivariate analysis identified detectable viral load as a significant risk factor for early neonatal adverse outcomes (aRR=4.036, CI=1.428-11.406, P=0.008). These findings underscore the importance of close monitoring and viral load suppression in HIV-positive mothers. Further research is needed to understand the causes of detectable viral loads in mothers on ART and to capture neonatal adverse outcomes beyond 7 days post-delivery. Keywords: HIV, Adverse neonatal outcomes, Antiretroviral therapy (ART), Viral load, Prematurity, Low birth weight, public health and Maternal health

Guidance for triangulating data and estimates of HIV prevalence among pregnant women and coverage of PMTCT using the Spectrum AIDS Impact Module.

Most countries use the Spectrum AIDS Impact Module (Spectrum-AIM), antenatal care routine HIV testing, and antiretroviral treatment data to estimate HIV prevalence among pregnant women. Non-representative programme data may lead to inaccurate estimates HIV prevalence and treatment coverage for pregnant women. 154 locations in 126 countries. Using 2023 UNAIDS HIV estimates, we calculated three ratios: (1) HIV prevalence among pregnant women to all women 15-49y (prevalence), (2) ART coverage before pregnancy to women 15-49y ART coverage (ART pre-pregnancy), and (3) ART coverage at delivery to women 15-49y ART coverage (PMTCT coverage). We developed an algorithm to identify and adjust inconsistent results within regional ranges in Spectrum-AIM, illustrated using Burkina Faso's estimates. In 2022, the mean regional ratio of prevalence among pregnant women to all women ranged from 0.68 to 0.95. ART coverage pre-pregnancy ranged by region from 0.40 to 1.22 times ART coverage among all women. Mean regional PMTCT coverage ratios ranged from 0.85 to 1.51. The prevalence ratio in Burkina Faso was 1.59, above the typical range 0.62-1.04 in western and central Africa. Antenatal clinics reported more PMTCT recipients than estimated HIV-positive pregnant women from 2015 to 2019. We adjusted inputted PMTCT programme data to enable consistency of HIV prevalence among pregnant women from programmatic routine HIV testing at antenatal clinics with values typical for Western and central Africa. These ratios offer Spectrum-AIM users a tool to gauge the consistency of their HIV prevalence and treatment coverage estimates among pregnant women with other countries in the region.

Fetal Clinical and Paraclinical Outcomes in HIV-Positive Pregnant Women.

Background Adverse pregnancy outcomes in women with human immunodeficiency virus (HIV) infection remain significantly increased. Untreated maternal infection primarily leads to fetal complications, such as intrauterine growth restriction, stillbirth, or preterm birth. Concerning both maternal and fetal complications that can appear in pregnancy associated with HIV infection, the purpose of the study was to determine fetal and maternal demographic characteristics and the correlation between blood count parameters and poor fetal prognosis. Methods We conducted a quantitative study utilizing document review as the data collection method. This study encompassed a cohort of nine HIV-positive pregnant women who delivered at the Obstetrics and Gynecology Department of the University Emergency Hospital in Bucharest from January 1, 2021, to December 31, 2023. A comparative cohort of nine healthy pregnant women who delivered during the same period in the same facility was selected using stratified random sampling. We examined maternal and fetal demographic parameters and neonatal outcomes, reporting them to paraclinical laboratory data. Results The incidence of pregnancy-related HIV infections was 0.16%. The mean age of patients in the selected group was 29.88 ± 5.53. There was no statistically significant correlation between maternal clinical and paraclinical parameters in the HIV-positive and HIV-negative groups. Although there was a slightly negative difference in the fetal weight at birth, the 1-min APGAR (appearance, pulse, grimace, activity, and respiration) score, and the intrauterine growth restriction between the two groups, there was a statistically significant association between admission to the neonatal intensive care unit (NICU) and the neonates from HIV-positive pregnancies. In our study, we observed preterm deliveries in 22.22% of cases, and we did not record any stillbirths. The 1-min APGAR score was correlated with the value of leukocytes in peripheral blood. Vertical transmission was established to be 11.11% independent of maternal blood count parameters. Conclusion HIV infection during pregnancy leads to a higher risk of admission to the NICU. Fetal leukocytosis is indicative of a lower 1-min APGAR score.The primary emphasis of therapeutic intervention during pregnancy should center on vigilant monitoring of maternal viral load and the timely administration of antiretroviral therapy to enhance fetal outcomes.

A retrospective analysis of maternal and pregnancy outcomes following PMTCT maternal cohort registration in a displaced setting.

Purpose: This study assessed the maternal and pregnancy outcomes following PMTCT cohort registration. Design: A retrospective analysis of HIV-positive pregnant women’s outcomes following enrollment in the Prevention of Mother-to-Child Transmission (PMTCT) maternal cohort register between January 2019 and December 2021 in FSP Daudu. Method: Using a checklist, data was collected from the folders and PMTCT maternal cohort register. Measures of interest included sociodemographic characteristics, maternal outcomes, and pregnancy outcomes. Findings: Of 223 identified HIV-positive pregnant women, 201 were enrolled in the program. However, only 189 maternal records met the inclusion criteria. Entry into the PMTCT program was mainly during the antenatal period, between 26 and 30 years of age with a mean gestational age of 15.2 weeks. Only 5.9% of the women reported facility delivery, and up to 70% had over 4 PMTCT follow-up visits before delivery (?2 = 6.825, P = 0.03). The Retention rate among the cohort was 98.4%, with 62% of the women being active throughout the program and over 86% having a live birth. Bivariate analysis suggested that aside from maternal age, similar factors affected maternal and pregnancy outcomes. Conclusions The active involvement and engagement of an HIV-positive pregnant woman in care can improve their health outcomes in times of displacement. Clinical evidence: Active follow-up and documentation constitute an effective strategy to improve PMTCT maternal retention in care and improve maternal outcomes. Further support by engaging community health workers in service delivery will create positive outcomes in the PMTCT program. Keywords: PMTCT, HIV/AIDs, Maternal health, Pregnancy.