Pregnancy Outcomes in Booked HIV Positive Women Initiating Highly Active Antiretroviral Therapy

Abstract

Pregnancy outcomes in HIV positive women remain a concern especially in sub-Saharan Africa which bears the highest burden of the disease. To evaluate pregnancy outcomes in booked preg-nant women on Highly Active Antiretroviral Therapy (HAART) at the University of Ilorin Teach-ing Hospital (UITH), Ilorin, Nigeria; a case control study (with women initiating HAART in preg-nancy as subjects and those who initiated it before pregnancy as control) of 268 HIV-positive wom-en managed between March 2009 and February 2013 was undertaken at the hospital. Inclusion cri-teria comprised HIV-positivity, booking, antenatal care and delivery at the study site. From the total of 8,958 women who had antenatal care during the period, 502 had HIV infection (prevalence 5.6%) out of which 268 satisfied the inclusion criteria and were enrolled into the study. Subjects were 54(20.2%) while 214(79.8%) were controls; the mean age of participants was 31.0±4.5 years while mean parity was 2.0±1.5. Pregnancy outcomes were worse in subjects with statistical signifi-cance in miscarriage (11.1% vs. 0.9%; OR 11.78, 95% CI 2.07-87.03, p <0.01), preterm delivery (31.5% vs. 1.9%; OR 24.35, 95% CI 7.15-91.26, p<0.01), term pregnancy (42.6% vs. 96.3%; OR 0.03, 95% CI 0.01-0.08, p<0.01), birth asphyxia (OR 8.31, 95% CI 3.25-21.45 p<0.01), low birth weight babies (OR 260.0, 95% CI 66.51-1142.77, p<0.01) and maternal puerperal complications (anaemia 35.2% vs. 0.9%; OR 68.79, 95% CI 14.28-452.19, p <0.01). Mother to child transmission of HIV was recorded in only 3(1.1%) babies among the subjects. Commencement of HAART before pregnancy appears to improve pregnancy outcomes in HIV positive women.

Keywords: Preterm, Miscarriage, birth weight, asphyxia, puerperal