Pregnancy loss in women with HIV is not associated with HIV markers: Data from a national study in Italy, 2001-2018

Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy

Research output: Contribution to journalArticle

Abstract

Background: There is limited information on pregnancy loss in women with HIV, and it is still debated whether HIV-related markers may play a role. Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease. Methods: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (<22 weeks) and stillbirth (≥22 weeks). Possible associations of pregnancy loss were evaluated in univariate and multivariate analyses. Results: Among 2696 eligible pregnancies reported between 2001 and 2018, 226 (8.4%) ended in pregnancy loss (miscarriage 198, 7.3%; stillbirth 28, 1.0%). In multivariate analyses, only older age (adjusted odds ratio [AOR] per additional year of age: 1.079, 95% confidence interval [CI] 1.046-1.113), HIV diagnosis before pregnancy (AOR: 2.533, 95%CI 1.407-4.561) and history of pregnancy loss (AOR: 1.625, 95%CI 1.178-2.243) were significantly associated with pregnancy loss. No significant association with pregnancy loss was found for parity, coinfections, sexually transmitted diseases, hypertension, smoking, alcohol and substance use, CD4 cell count, HIV-RNA viral load, and CDC HIV stage. Conclusions: Older women and those with a previous history of pregnancy loss should be considered at higher risk of pregnancy loss. The severity of HIV disease and potentially modifiable risk factors did not increase the risk of pregnancy loss.

Original languageEnglish
Article numbere2019050
JournalMediterranean Journal of Hematology and Infectious Diseases
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Italy
HIV
Pregnancy
Reproductive History
Stillbirth
Odds Ratio
Spontaneous Abortion
Confidence Intervals
Multivariate Analysis
High-Risk Pregnancy
Centers for Disease Control and Prevention (U.S.)
CD4 Lymphocyte Count
Sexually Transmitted Diseases
Parity
Viral Load
Coinfection
Multicenter Studies
Observational Studies
Pregnant Women
Smoking

Keywords

  • CD4 cell count
  • HIV
  • Miscarriage
  • Pregnancy loss
  • Stillbirth

ASJC Scopus subject areas

  • Hematology
  • Infectious Diseases

Cite this

Pregnancy loss in women with HIV is not associated with HIV markers : Data from a national study in Italy, 2001-2018. / Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy.

In: Mediterranean Journal of Hematology and Infectious Diseases, Vol. 11, No. 1, e2019050, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Pregnancy loss in women with HIV is not associated with HIV markers: Data from a national study in Italy, 2001-2018",
abstract = "Background: There is limited information on pregnancy loss in women with HIV, and it is still debated whether HIV-related markers may play a role. Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease. Methods: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (<22 weeks) and stillbirth (≥22 weeks). Possible associations of pregnancy loss were evaluated in univariate and multivariate analyses. Results: Among 2696 eligible pregnancies reported between 2001 and 2018, 226 (8.4{\%}) ended in pregnancy loss (miscarriage 198, 7.3{\%}; stillbirth 28, 1.0{\%}). In multivariate analyses, only older age (adjusted odds ratio [AOR] per additional year of age: 1.079, 95{\%} confidence interval [CI] 1.046-1.113), HIV diagnosis before pregnancy (AOR: 2.533, 95{\%}CI 1.407-4.561) and history of pregnancy loss (AOR: 1.625, 95{\%}CI 1.178-2.243) were significantly associated with pregnancy loss. No significant association with pregnancy loss was found for parity, coinfections, sexually transmitted diseases, hypertension, smoking, alcohol and substance use, CD4 cell count, HIV-RNA viral load, and CDC HIV stage. Conclusions: Older women and those with a previous history of pregnancy loss should be considered at higher risk of pregnancy loss. The severity of HIV disease and potentially modifiable risk factors did not increase the risk of pregnancy loss.",
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author = "{Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy} and Marco Floridia and Giulia Masuelli and Beatrice Tassis and Enrica Tamburrini and Valeria Savasi and Matilde Sansone and Arsenio Spinillo and Giuseppina Liuzzi and Antoni, {Anna Degli} and Serena Dalzero and Laura Franceschetti and Giuliana Simonazzi and Gianpaolo Maso and Daniela Francisci and Carmela Pinnetti and Marina Ravizza",
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T1 - Pregnancy loss in women with HIV is not associated with HIV markers

T2 - Data from a national study in Italy, 2001-2018

AU - Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy

AU - Floridia, Marco

AU - Masuelli, Giulia

AU - Tassis, Beatrice

AU - Tamburrini, Enrica

AU - Savasi, Valeria

AU - Sansone, Matilde

AU - Spinillo, Arsenio

AU - Liuzzi, Giuseppina

AU - Antoni, Anna Degli

AU - Dalzero, Serena

AU - Franceschetti, Laura

AU - Simonazzi, Giuliana

AU - Maso, Gianpaolo

AU - Francisci, Daniela

AU - Pinnetti, Carmela

AU - Ravizza, Marina

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: There is limited information on pregnancy loss in women with HIV, and it is still debated whether HIV-related markers may play a role. Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease. Methods: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (<22 weeks) and stillbirth (≥22 weeks). Possible associations of pregnancy loss were evaluated in univariate and multivariate analyses. Results: Among 2696 eligible pregnancies reported between 2001 and 2018, 226 (8.4%) ended in pregnancy loss (miscarriage 198, 7.3%; stillbirth 28, 1.0%). In multivariate analyses, only older age (adjusted odds ratio [AOR] per additional year of age: 1.079, 95% confidence interval [CI] 1.046-1.113), HIV diagnosis before pregnancy (AOR: 2.533, 95%CI 1.407-4.561) and history of pregnancy loss (AOR: 1.625, 95%CI 1.178-2.243) were significantly associated with pregnancy loss. No significant association with pregnancy loss was found for parity, coinfections, sexually transmitted diseases, hypertension, smoking, alcohol and substance use, CD4 cell count, HIV-RNA viral load, and CDC HIV stage. Conclusions: Older women and those with a previous history of pregnancy loss should be considered at higher risk of pregnancy loss. The severity of HIV disease and potentially modifiable risk factors did not increase the risk of pregnancy loss.

AB - Background: There is limited information on pregnancy loss in women with HIV, and it is still debated whether HIV-related markers may play a role. Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease. Methods: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (<22 weeks) and stillbirth (≥22 weeks). Possible associations of pregnancy loss were evaluated in univariate and multivariate analyses. Results: Among 2696 eligible pregnancies reported between 2001 and 2018, 226 (8.4%) ended in pregnancy loss (miscarriage 198, 7.3%; stillbirth 28, 1.0%). In multivariate analyses, only older age (adjusted odds ratio [AOR] per additional year of age: 1.079, 95% confidence interval [CI] 1.046-1.113), HIV diagnosis before pregnancy (AOR: 2.533, 95%CI 1.407-4.561) and history of pregnancy loss (AOR: 1.625, 95%CI 1.178-2.243) were significantly associated with pregnancy loss. No significant association with pregnancy loss was found for parity, coinfections, sexually transmitted diseases, hypertension, smoking, alcohol and substance use, CD4 cell count, HIV-RNA viral load, and CDC HIV stage. Conclusions: Older women and those with a previous history of pregnancy loss should be considered at higher risk of pregnancy loss. The severity of HIV disease and potentially modifiable risk factors did not increase the risk of pregnancy loss.

KW - CD4 cell count

KW - HIV

KW - Miscarriage

KW - Pregnancy loss

KW - Stillbirth

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