Comparable Pregnancy Outcomes for HIV-Uninfected and HIV-Infected Women on Antiretroviral Treatment in Kenya. (11th April 2022)

• Record Type: Journal Article
• Authors: Mugo, Cyrus; Nduati, Ruth; Osoro, Eric; Nyawanda, Bryan O; Mirieri, Harriet; Hunsperger, Elizabeth; Verani, Jennifer R; Jin, Hafsa; Mwaengo, Dufton; Maugo, Brian; Machoki, James; Otieno, Nancy A; Ombok, Cynthia; Shabibi, Mufida; Okutoyi, Lydia; Kinuthia, John; Widdowson, Marc Alain; Njenga, Kariuki; Inwani, Irene; Wamalwa, Dalton
• Is Part Of: Journal of infectious diseases. Volume 226:Number 4(2022)
• Page Start: 678
• Page End: 686
• Publication Date: 2022-04-11
• Subjects: HIV -- antiretroviral therapy -- test and treat -- pregnancy loss -- prematurity -- low birth weight -- sub-Saharan Africa; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiac128
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: The impact of human immunodeficiency virus (HIV) on pregnancy outcomes for women on antiretroviral therapy (ART) in sub-Saharan Africa remains unclear. Methods: Pregnant women in Kenya were enrolled in the second trimester and followed up to delivery. We estimated effects of treated HIV with 3 pregnancy outcomes: loss, premature birth, and low birth weight and factors associated with HIV-positive status. Results: Of 2113 participants, 311 (15%) were HIV infected and on ART. Ninety-one of 1762 (5%) experienced a pregnancy loss, 169/1725 (10%) a premature birth (<37 weeks), and 74/1317 (6%) had a low-birth-weight newborn (<2500 g). There was no evidence of associations between treated HIV infection and pregnancy loss (adjusted relative risk [aRR], 1.19; 95% confidence interval [CI], .65–2.16; P = .57), prematurity (aRR, 1.09; 95% CI, .70–1.70; P = .69), and low birth weight (aRR, 1.36; 95% CI, .77–2.40; P = .27). Factors associated with an HIV-positive status included older age, food insecurity, lower education level, higher parity, lower gestation at first antenatal clinic, anemia, and syphilis. Women who were overweight or underweight were less likely to be HIV infected compared to those with normal weight. Conclusions: Currently treated HIV was not significantly associated with adverse pregnancy outcomes. HIV-infected women, however, had a higher prevalence of other factors associated with adverse pregnancy outcomes. Abstract : We estimated the effect of currently treated HIV on pregnancy loss, prematurity, and low birth weight. We found no differences in the risk of the 3 adverse pregnancy outcomes between pregnant HIV-uninfected women and HIV-infected women on antiretroviral treatment.