Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

M. Floridia, E. Tamburrini, G. Masuelli, P. Martinelli, A. Spinillo, G. Liuzzi, A. Vimercati, S. Alberico, A. Maccabruni, C. Pinnetti, V. Frisina, S. Dalzero, M. Ravizza, Italian Group for Surveillance of Antiretroviral Treatment in Pregnancy

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. METHODS: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. RESULTS: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/muL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). CONCLUSIONS: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.
Original languageEnglish
Pages (from-to)440-443
Number of pages4
JournalHIV Medicine
Volume18
Issue number6
DOIs
Publication statusPublished - Jul 1 2017

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Pregnancy Outcome
HIV
Pregnancy
HIV Infections
Odds Ratio
Low Birth Weight Infant
Confidence Intervals
Pregnancy Rate
Centers for Disease Control and Prevention (U.S.)
CD4 Lymphocyte Count
Viral Load
Birth Weight
Pregnant Women
Mothers
RNA

Keywords

  • HIV
  • HIV RNA
  • birth weight
  • pregnancy
  • preterm delivery

Cite this

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., ... Pregnancy, I. G. F. S. O. A. T. I. (2017). Rate, correlates and outcomes of repeat pregnancy in HIV-infected women. HIV Medicine, 18(6), 440-443. https://doi.org/10.1111/hiv.12473 [doi]

Rate, correlates and outcomes of repeat pregnancy in HIV-infected women. / Floridia, M.; Tamburrini, E.; Masuelli, G.; Martinelli, P.; Spinillo, A.; Liuzzi, G.; Vimercati, A.; Alberico, S.; Maccabruni, A.; Pinnetti, C.; Frisina, V.; Dalzero, S.; Ravizza, M.; Pregnancy, Italian Group for Surveillance of Antiretroviral Treatment in.

In: HIV Medicine, Vol. 18, No. 6, 01.07.2017, p. 440-443.

Research output: Contribution to journalArticle

Floridia, M, Tamburrini, E, Masuelli, G, Martinelli, P, Spinillo, A, Liuzzi, G, Vimercati, A, Alberico, S, Maccabruni, A, Pinnetti, C, Frisina, V, Dalzero, S, Ravizza, M & Pregnancy, IGFSOATI 2017, 'Rate, correlates and outcomes of repeat pregnancy in HIV-infected women', HIV Medicine, vol. 18, no. 6, pp. 440-443. https://doi.org/10.1111/hiv.12473 [doi]
Floridia, M. ; Tamburrini, E. ; Masuelli, G. ; Martinelli, P. ; Spinillo, A. ; Liuzzi, G. ; Vimercati, A. ; Alberico, S. ; Maccabruni, A. ; Pinnetti, C. ; Frisina, V. ; Dalzero, S. ; Ravizza, M. ; Pregnancy, Italian Group for Surveillance of Antiretroviral Treatment in. / Rate, correlates and outcomes of repeat pregnancy in HIV-infected women. In: HIV Medicine. 2017 ; Vol. 18, No. 6. pp. 440-443.
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T1 - Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

AU - Floridia, M.

AU - Tamburrini, E.

AU - Masuelli, G.

AU - Martinelli, P.

AU - Spinillo, A.

AU - Liuzzi, G.

AU - Vimercati, A.

AU - Alberico, S.

AU - Maccabruni, A.

AU - Pinnetti, C.

AU - Frisina, V.

AU - Dalzero, S.

AU - Ravizza, M.

AU - Pregnancy, Italian Group for Surveillance of Antiretroviral Treatment in

N1 - LR: 20170605; CI: (c) 2016; JID: 100897392; OTO: NOTNLM; 2016/09/21 00:00 [accepted]; 2016/12/22 06:00 [pubmed]; 2016/12/22 06:00 [medline]; 2016/12/22 06:00 [entrez]; ppublish

PY - 2017/7/1

Y1 - 2017/7/1

N2 - OBJECTIVES: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. METHODS: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. RESULTS: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/muL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). CONCLUSIONS: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

AB - OBJECTIVES: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. METHODS: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. RESULTS: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/muL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). CONCLUSIONS: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

KW - HIV

KW - HIV RNA

KW - birth weight

KW - pregnancy

KW - preterm delivery

U2 - 10.1111/hiv.12473 [doi]

DO - 10.1111/hiv.12473 [doi]

M3 - Article

VL - 18

SP - 440

EP - 443

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 6

ER -