Obstetric and newborn infant outcomes in human immunodeficiency virus–infected women who receive highly active antiretroviral therapy

Objective

Our aim was to examine perinatal outcomes in women who are infected with human immunodeficiency virus (HIV) and who receive highly active antiretroviral therapy compared with the general population.

Study Design

In this retrospective cohort study, we compared 151 HIV-positive and 302 HIV-negative women. We defined highly active antiretroviral therapy as concomitant use of at least 3 antiretroviral drugs. We calculated frequencies and odds ratios for adverse pregnancy outcomes.

Results

Compared with control subjects, smoking (odds ratio, 4.62; 95% confidence interval [CI], 2.58–8.27), drug abuse (odds ratio, 5.48; 95% CI, 2.21–13.59), and spontaneous preterm birth (adjusted odds ratio, 2.27; 95% CI, 1.22–4.25) were more common among HIV-positive women. HIV-positive women were more likely to deliver a small-for-gestational-age infant, but this was due to higher tobacco and cocaine use. Neonatal outcomes were otherwise similar.

Conclusion

HIV-positive women are at increased risk for preterm birth and lower birthweight infants; therefore, antenatal surveillance should include fetal growth assessment. Highly active antiretroviral therapy use does not increase maternal complications.

Key words: highly active antiretroviral therapy, human immunodeficiency virus, low birthweight, pregnancy, preterm birth