Maternal and fetal outcomes among hiv positive pregnant mothers attending antenatal clinic at university of maiduguri teaching hospital Maiduguri Nigeria

Abstract

To determine the pregnancy outcome among HIV positive women attending ANC at the University of Maiduguri Teaching Hospital, Maiduguri. Method: A prospective cohort study of 500 women attending the ANC between 12 August 2009-21 December 2010 was carried out. Initial HIV screening was done using single rapid tests, while diagnosis for those found positive was done with an additional second rapid test, while confirmation is done with 'Western Blot' technique. Socio demographic and obstetrics variables were obtained and analyzed. Results: Out of the 500 pregnant mothers that were counseled and tested for HIV, 52 were found to be HIV positive giving a sero prevalence rate of 10.4%. The HIV positive women are used as cases while out of the remaining cohort 162 patients that are matched for age and parity were used as control. The perinatal transmission rate was 11.5%. The HIV positive women were more educated and younger than the control. More than 90% of the HIV positive women booked for ANC between 2 and 3 trimester with average gestational age at booking of 29.3 weeks. Elective caesarean section (ELCS) was offered to 11(21.2%) and all the babies delivered through ELCS were negative for HIV. Prematurity, low birth weight and birth asphyxia were more in HIV positive women than control. Advanced maternal age (X =33.53 P =0.000), Low CD4 count (X =15.58 P =0.016), high maternal viral load (X =21.85 P =0.005), 2 prematurity (X2= 9.872 P= 0.007), low birth weight (X = 63.80 P= 0.000) and birth 2 asphyxia(X = 24.149 P= 0.000) were the major determinants of perinatal transmission of HIV infection in this study. Conclusion: The Seroprevalence and MTCT of HIV infection in pregnancy is high in our environment. HIV infection was also found to be associated with increases risk of elective caesarean section and neonatal asphyxia. Efforts should be intensified to improve the situation.