Rate, correlates and outcomes of repeat pregnancy in HIV‐infected women. Issue 6 (21st December 2016)

• Record Type: Journal Article
• Authors: Floridia, M; Tamburrini, E; Masuelli, G; Martinelli, P; Spinillo, A; Liuzzi, G; Vimercati, A; Alberico, S; Maccabruni, A; Pinnetti, C; Frisina, V; Dalzero, S; Ravizza, M
• Other Names: Mori F. investigator.; Ortolani P. investigator.; dalle Nogare E. R. investigator.; Di Lorenzo F. investigator.; Sterrantino G. investigator.; Meli M. investigator.; Polemi S. investigator.; Nocentini J. investigator.; Baldini M. investigator.; Montorzi G. investigator.; Mazzetti M. investigator.; Rogasi P. investigator.; Borchi B. investigator.; Vichi F. investigator.; Del Pin B. investigator.; Pinter E. investigator.; Anzalone E. investigator.; Marocco R. investigator.; Mastroianni C. investigator.; Mercurio V. S. investigator.; Carocci A. investigator.; Grilli E. investigator.; Zaramella M. investigator.; Mariani B. investigator.; Natalini Raponi G. investigator.; Guaraldi G. investigator.; Nardini G. investigator.; Stentarelli C. investigator.; Beghetto B. investigator.; Degli Antoni A. M. investigator.; Molinari A. investigator.; Crisalli M. P. investigator.; Donisi A. investigator.; Piepoli M. investigator.; Cerri V. investigator.; Zuccotti G. investigator.; Giacomet V. investigator.; Coletto S. investigator.; Di Nello F. investigator.; Madia C. investigator.; Placido G. investigator.; Vivarelli A. investigator.; Castelli P. investigator.; Savalli F. investigator.; Portelli V. investigator.; Sabbatini F. investigator.; Francisci D. investigator.; Bernini L. investigator.; Grossi P. investigator.; Rizzi L. investigator.; Maso G. investigator.; Airoud M. investigator.; Soppelsa G. investigator.; Meloni A. investigator.; Dedoni M. investigator.; Cuboni C. investigator.; Ortu F. investigator.; Piano P. investigator.; Citernesi A. investigator.; Bordoni Vicini I. investigator.; Luzi K. investigator.; Roccio M. investigator.; Miccolis A. investigator.; De Gennaro A. investigator.; Guerra B. investigator.; Cervi F. investigator.; Simonazzi G. investigator.; Margarito E. investigator.; Capretti M. G. investigator.; Marsico C. investigator.; Faldella G. investigator.; Sansone M. investigator.; Agangi A. investigator.; Capone A. investigator.; Maruotti M. investigator.; Tibaldi C. investigator.; Trentini L. investigator.; Todros T. investigator.; Cetin I. investigator.; Brambilla T. investigator.; Savasi V. investigator.; Personeni C. investigator.; Giaquinto C. investigator.; Fiscon M. investigator.; Rubino E. investigator.; Bucceri A. investigator.; Matrone R. investigator.; Scaravelli G. investigator.; Genovese O. investigator.; Cafforio C. investigator.; Tozzi V. investigator.; Massetti P. investigator.; Casadei A. M. investigator.; Cavaliere A. F. investigator.; Cellini M. investigator.; Castelli Gattinara G. investigator.; Marconi A. M. investigator.; Sacchi V. investigator.; Ierardi M. investigator.; Polizzi C. investigator.; Mattei A. investigator.; Pirillo M. F. investigator.; Amici R. investigator.; Galluzzo C. M. investigator.; Donnini S. investigator.; Baroncelli S. investigator.; Villani P. investigator.; Cusato M. investigator.; Cerioli A. investigator.; De Martino M. investigator.; Mastroiacovo P. investigator.; Parazzini F. investigator.; Vella S. investigator.;
• Is Part Of: HIV medicine. Volume 18:Issue 6(2017:Jul.)
• Page Start: 440
• Page End: 443
• Publication Date: 2016-12-21
• Subjects: birth weight -- HIV -- HIV RNA -- pregnancy -- preterm delivery; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12473
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs . 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs . 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs . 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs . 61 kg, respectively), a higher rate of end‐of‐pregnancy undetectable HIV RNA (60.7 vs . 71.6%, respectively), a higher median birth weight (2815 vs . 2885 g, respectively), lower rates of preterm delivery (23.0 vs . 17.7%, respectively) and of low birth weight (23.4 vs . 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC‐C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs . 6.1%, respectively). Conclusions: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.