Objectives
Human immunodeficiency virus-infected (HIV+) women have been shown to be at higher risk of obstetric and perinatal morbidity compared with the HIV-uninfected (HIV-) population. Our primary objective was to assess the association of HIV with preterm birth in a southern US cohort; a secondary outcome was to assess the association of HIV with neonatal outcomes.
Methods
HIV-infected women undergoing pregnancy and delivery during 2000-2014 at a southern US medical center were studied. Women delivering in the same year as the HIV-infected women were randomly chosen as controls in a 1:1 fashion. Medical records were reviewed, and data on demographics, clinical variables, and pregnancy and neonatal outcomes were abstracted. Frequency analysis and logistic regression were performed, and chi-square values and odds ratios with 95% confidence intervals were calculated.
Methods
HIV-infected women undergoing pregnancy and delivery during 2000-2014 at a southern US medical center were studied. Women delivering in the same year as the HIV-infected women were randomly chosen as controls in a 1:1 fashion. Medical records were reviewed, and data on demographics, clinical variables, and pregnancy and neonatal outcomes were abstracted. Frequency analysis and logistic regression were performed, and chi-square values and odds ratios with 95% confidence intervals were calculated.
Results
The cohort was comprised of 210 HIV+ women and 222 HIV- women who underwent pregnancy and delivery from 2000-2014. HIV+ women were more likely than HIV- women to be older (mean age 27.3 years, SD 5.8 vs. 25.9 years, SD 6.5; p=.01), Black (p<.0001), obese (p=.0003, unmarried (p=.02), to report crack/cocaine use (p=.02), and to have sexually transmitted infections during pregnancy (p=.0002). In unadjusted analyses, there were no significant differences between HIV+ and HIV- women for preterm birth <37 weeks, <28 weeks, birth weight, Apgar scores, NICU admission, or neonatal death, however HIV+ women were less likely to have preterm birth <34 weeks compared with HIV- women (OR=0.44, 95% CI 0.23-0.84) (Table). After adjustment, there was no significant difference in preterm birth <34 weeks (Table).
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