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, The Italian Group for Surveillance of Antiretroviral Treatment in Pregnancy, F. Mori, P. Ortolani, E.R. dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli & 30 others S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, B. Del Pin, E. Pinter, E. Grilli, B. Mariani, G. Nardini, A. Molinari, F. Sabbatini, P. Grossi, G. Maso, M. Roccio, A. Capone, A. Bucceri, G. Scaravelli, G. Castelli Gattinara, M.F. Pirillo, R. Amici, C.M. Galluzzo, S. Baroncelli, P. Villani, M. Cusato, F. Parazzini, S. Vella

Research output: Contribution to journalArticle

2 Citations (Scopus)

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/μL), 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. © 2016 British HIV Association
Original languageEnglish
Pages (from-to)440-443
Number of pages4
JournalHIV Medicine
Volume18
Issue number6
DOIs
Publication statusPublished - 2017

Fingerprint

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

  • birth weight
  • HIV
  • HIV RNA
  • pregnancy
  • preterm delivery
  • anti human immunodeficiency virus agent
  • virus RNA
  • adult
  • age
  • antiretroviral therapy
  • Article
  • body weight
  • CD4 lymphocyte count
  • female
  • human
  • Human immunodeficiency virus
  • Human immunodeficiency virus infected patient
  • Human immunodeficiency virus infection
  • low birth weight
  • major clinical study
  • pregnancy outcome
  • pregnancy rate
  • pregnancy termination
  • pregnant woman
  • premature labor
  • primigravida
  • priority journal
  • social determinants of health
  • virus load

Cite this

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., ... Vella, S. (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

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, The Italian Group for Surveillance of Antiretroviral Treatment in; Mori, F.; Ortolani, P.; dalle Nogare, E.R.; Di Lorenzo, F.; Sterrantino, G.; Meli, M.; Polemi, S.; Nocentini, J.; Baldini, M.; Montorzi, G.; Mazzetti, M.; Rogasi, P.; Borchi, B.; Vichi, F.; Del Pin, B.; Pinter, E.; Grilli, E.; Mariani, B.; Nardini, G.; Molinari, A.; Sabbatini, F.; Grossi, P.; Maso, G.; Roccio, M.; Capone, A.; Bucceri, A.; Scaravelli, G.; Castelli Gattinara, G.; Pirillo, M.F.; Amici, R.; Galluzzo, C.M.; Baroncelli, S.; Villani, P.; Cusato, M.; Parazzini, F.; Vella, S.

In: HIV Medicine, Vol. 18, No. 6, 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, TIGFSOATI, Mori, F, Ortolani, P, dalle Nogare, ER, Di Lorenzo, F, Sterrantino, G, Meli, M, Polemi, S, Nocentini, J, Baldini, M, Montorzi, G, Mazzetti, M, Rogasi, P, Borchi, B, Vichi, F, Del Pin, B, Pinter, E, Grilli, E, Mariani, B, Nardini, G, Molinari, A, Sabbatini, F, Grossi, P, Maso, G, Roccio, M, Capone, A, Bucceri, A, Scaravelli, G, Castelli Gattinara, G, Pirillo, MF, Amici, R, Galluzzo, CM, Baroncelli, S, Villani, P, Cusato, M, Parazzini, F & Vella, S 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
Floridia M, Tamburrini E, Masuelli G, Martinelli P, Spinillo A, Liuzzi G et al. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women. HIV Medicine. 2017;18(6):440-443. https://doi.org/10.1111/hiv.12473
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, The Italian Group for Surveillance of Antiretroviral Treatment in ; Mori, F. ; Ortolani, P. ; dalle Nogare, E.R. ; Di Lorenzo, F. ; Sterrantino, G. ; Meli, M. ; Polemi, S. ; Nocentini, J. ; Baldini, M. ; Montorzi, G. ; Mazzetti, M. ; Rogasi, P. ; Borchi, B. ; Vichi, F. ; Del Pin, B. ; Pinter, E. ; Grilli, E. ; Mariani, B. ; Nardini, G. ; Molinari, A. ; Sabbatini, F. ; Grossi, P. ; Maso, G. ; Roccio, M. ; Capone, A. ; Bucceri, A. ; Scaravelli, G. ; Castelli Gattinara, G. ; Pirillo, M.F. ; Amici, R. ; Galluzzo, C.M. ; Baroncelli, S. ; Villani, P. ; Cusato, M. ; Parazzini, F. ; Vella, S. / 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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title = "Rate, correlates and outcomes of repeat pregnancy in HIV-infected women",
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/μL), 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. {\circledC} 2016 British HIV Association",
keywords = "birth weight, HIV, HIV RNA, pregnancy, preterm delivery, anti human immunodeficiency virus agent, virus RNA, adult, age, antiretroviral therapy, Article, body weight, CD4 lymphocyte count, female, human, Human immunodeficiency virus, Human immunodeficiency virus infected patient, Human immunodeficiency virus infection, low birth weight, major clinical study, pregnancy outcome, pregnancy rate, pregnancy termination, pregnant woman, premature labor, primigravida, priority journal, social determinants of health, virus load",
author = "M. Floridia and E. Tamburrini and G. Masuelli and P. Martinelli and A. Spinillo and G. Liuzzi and A. Vimercati and S. Alberico and A. Maccabruni and C. Pinnetti and V. Frisina and S. Dalzero and M. Ravizza and Pregnancy, {The Italian Group for Surveillance of Antiretroviral Treatment in} and F. Mori and P. Ortolani and {dalle Nogare}, E.R. and {Di Lorenzo}, F. and G. Sterrantino and M. Meli and S. Polemi and J. Nocentini and M. Baldini and G. Montorzi and M. Mazzetti and P. Rogasi and B. Borchi and F. Vichi and {Del Pin}, B. and E. Pinter and E. Grilli and B. Mariani and G. Nardini and A. Molinari and F. Sabbatini and P. Grossi and G. Maso and M. Roccio and A. Capone and A. Bucceri and G. Scaravelli and {Castelli Gattinara}, G. and M.F. Pirillo and R. Amici and C.M. Galluzzo and S. Baroncelli and P. Villani and M. Cusato and F. Parazzini and S. Vella",
note = "Cited By :1 Export Date: 19 April 2018 CODEN: HMIEA Correspondence Address: Floridia, M.; Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanit{\`a}Italy; email: marco.floridia@iss.it Funding details: H85E08000200005, ISS, Istituto Superiore di Sanit{\`a} Funding details: AIFA, Agenzia Italiana del Farmaco, Ministero della Salute Funding details: HHMI, Howard Hughes Medical Institute Funding details: NIH, National Institutes of Health Funding details: Wellcome Trust Funding text: We thank Cosimo Polizzi and Alessandra Mattei of the Istituto Superiore di Sanit? in Rome, Italy, for providing technical secretarial support for this study. No compensation was received for this contribution. Conflicts of interest: The authors report no conflicts of interest. Funding: This work was supported by public research grants (ref.: H85E08000200005) from the Italian Medicines Agency (AIFA). No funding was received for this work from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, and the Howard Hughes Medical Institute (HHMI). The funder had no role in the study design, data collection, data analysis, manuscript preparation and/or publication decision. References: Cliffe, S., Townsend, C.L., Cortina-Borja, M., Newell, M.L., Fertility intentions of HIV-infected women in the United Kingdom (2011) AIDS Care, 23, pp. 1093-1101; Hernando, V., Alejos, B., {\'A}lvarez, D., Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study (2014) BMC Pregnancy Childbirth, 14, p. 194; French, C.E., Cortina-Borja, M., Thorne, C., Tookey, P.A., Incidence, patterns, and predictors of repeat pregnancies among HIV-infected women in the United Kingdom and Ireland, 1990–2009 (2012) J Acquir Immune Defic Syndr, 59, pp. 287-293; Floridia, M., Ravizza, M., Tamburrini, E., Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy (2006) Epidemiol Infect, 134, pp. 1120-1127; Bertino, E., Spada, E., Occhi, L., Neonatal anthropometric charts: the Italian neonatal study compared with other European studies (2010) J Pediatr Gastroenterol Nutr, 51, pp. 353-361; Bryant, A.S., Leighty, R.M., Shen, X., Predictors of repeat pregnancy among HIV-1-infected women (2007) J Acquir Immune Defic Syndr, 44, pp. 87-92; Friedman, R.K., Bastos, F.I., Leite, I.C., Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil (2011) Rev Saude Publica, 45, pp. 373-381; Akelo, V., McLellan-Lemal, E., Toledo, L., Determinants and experiences of repeat pregnancy among HIV-positive Kenyan women - a mixed-methods analysis (2015) PLoS One, 10; Kreitchmann, R., Megazzini, K., Melo, V.H., Repeat pregnancy in women with HIV infection in Latin America and the Caribbean (2015) AIDS Care, 27, pp. 1289-1297; (2013) Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Recommendations for a Public Health Approach, , Geneva, Switzerland, World Health Organization; Short, C.E., Douglas, M., Smith, J.H., Taylor, G.P., Preterm delivery risk in women initiating antiretroviral therapy to prevent HIV mother-to-child transmission (2014) HIV Med, 15, pp. 233-238; French, C.E., Thorne, C., Tariq, S., Cortina-Borja, M., Tookey, P.A., Immunologic status and virologic outcomes in repeat pregnancies to HIV-positive women not on antiretroviral therapy at conception: a case for lifelong antiretroviral therapy? (2014) AIDS, 28, pp. 1369-1372",
year = "2017",
doi = "10.1111/hiv.12473",
language = "English",
volume = "18",
pages = "440--443",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Blackwell Publishing Ltd",
number = "6",

}

TY - JOUR

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, The Italian Group for Surveillance of Antiretroviral Treatment in

AU - Mori, F.

AU - Ortolani, P.

AU - dalle Nogare, E.R.

AU - Di Lorenzo, F.

AU - Sterrantino, G.

AU - Meli, M.

AU - Polemi, S.

AU - Nocentini, J.

AU - Baldini, M.

AU - Montorzi, G.

AU - Mazzetti, M.

AU - Rogasi, P.

AU - Borchi, B.

AU - Vichi, F.

AU - Del Pin, B.

AU - Pinter, E.

AU - Grilli, E.

AU - Mariani, B.

AU - Nardini, G.

AU - Molinari, A.

AU - Sabbatini, F.

AU - Grossi, P.

AU - Maso, G.

AU - Roccio, M.

AU - Capone, A.

AU - Bucceri, A.

AU - Scaravelli, G.

AU - Castelli Gattinara, G.

AU - Pirillo, M.F.

AU - Amici, R.

AU - Galluzzo, C.M.

AU - Baroncelli, S.

AU - Villani, P.

AU - Cusato, M.

AU - Parazzini, F.

AU - Vella, S.

N1 - Cited By :1 Export Date: 19 April 2018 CODEN: HMIEA Correspondence Address: Floridia, M.; Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di SanitàItaly; email: marco.floridia@iss.it Funding details: H85E08000200005, ISS, Istituto Superiore di Sanità Funding details: AIFA, Agenzia Italiana del Farmaco, Ministero della Salute Funding details: HHMI, Howard Hughes Medical Institute Funding details: NIH, National Institutes of Health Funding details: Wellcome Trust Funding text: We thank Cosimo Polizzi and Alessandra Mattei of the Istituto Superiore di Sanit? in Rome, Italy, for providing technical secretarial support for this study. No compensation was received for this contribution. Conflicts of interest: The authors report no conflicts of interest. Funding: This work was supported by public research grants (ref.: H85E08000200005) from the Italian Medicines Agency (AIFA). No funding was received for this work from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, and the Howard Hughes Medical Institute (HHMI). The funder had no role in the study design, data collection, data analysis, manuscript preparation and/or publication decision. References: Cliffe, S., Townsend, C.L., Cortina-Borja, M., Newell, M.L., Fertility intentions of HIV-infected women in the United Kingdom (2011) AIDS Care, 23, pp. 1093-1101; Hernando, V., Alejos, B., Álvarez, D., Reproductive desire in women with HIV infection in Spain, associated factors and motivations: a mixed-method study (2014) BMC Pregnancy Childbirth, 14, p. 194; French, C.E., Cortina-Borja, M., Thorne, C., Tookey, P.A., Incidence, patterns, and predictors of repeat pregnancies among HIV-infected women in the United Kingdom and Ireland, 1990–2009 (2012) J Acquir Immune Defic Syndr, 59, pp. 287-293; Floridia, M., Ravizza, M., Tamburrini, E., Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy (2006) Epidemiol Infect, 134, pp. 1120-1127; Bertino, E., Spada, E., Occhi, L., Neonatal anthropometric charts: the Italian neonatal study compared with other European studies (2010) J Pediatr Gastroenterol Nutr, 51, pp. 353-361; Bryant, A.S., Leighty, R.M., Shen, X., Predictors of repeat pregnancy among HIV-1-infected women (2007) J Acquir Immune Defic Syndr, 44, pp. 87-92; Friedman, R.K., Bastos, F.I., Leite, I.C., Pregnancy rates and predictors in women with HIV/AIDS in Rio de Janeiro, Southeastern Brazil (2011) Rev Saude Publica, 45, pp. 373-381; Akelo, V., McLellan-Lemal, E., Toledo, L., Determinants and experiences of repeat pregnancy among HIV-positive Kenyan women - a mixed-methods analysis (2015) PLoS One, 10; Kreitchmann, R., Megazzini, K., Melo, V.H., Repeat pregnancy in women with HIV infection in Latin America and the Caribbean (2015) AIDS Care, 27, pp. 1289-1297; (2013) Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Recommendations for a Public Health Approach, , Geneva, Switzerland, World Health Organization; Short, C.E., Douglas, M., Smith, J.H., Taylor, G.P., Preterm delivery risk in women initiating antiretroviral therapy to prevent HIV mother-to-child transmission (2014) HIV Med, 15, pp. 233-238; French, C.E., Thorne, C., Tariq, S., Cortina-Borja, M., Tookey, P.A., Immunologic status and virologic outcomes in repeat pregnancies to HIV-positive women not on antiretroviral therapy at conception: a case for lifelong antiretroviral therapy? (2014) AIDS, 28, pp. 1369-1372

PY - 2017

Y1 - 2017

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/μL), 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. © 2016 British HIV Association

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/μL), 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. © 2016 British HIV Association

KW - birth weight

KW - HIV

KW - HIV RNA

KW - pregnancy

KW - preterm delivery

KW - anti human immunodeficiency virus agent

KW - virus RNA

KW - adult

KW - age

KW - antiretroviral therapy

KW - Article

KW - body weight

KW - CD4 lymphocyte count

KW - female

KW - human

KW - Human immunodeficiency virus

KW - Human immunodeficiency virus infected patient

KW - Human immunodeficiency virus infection

KW - low birth weight

KW - major clinical study

KW - pregnancy outcome

KW - pregnancy rate

KW - pregnancy termination

KW - pregnant woman

KW - premature labor

KW - primigravida

KW - priority journal

KW - social determinants of health

KW - virus load

U2 - 10.1111/hiv.12473

DO - 10.1111/hiv.12473

M3 - Article

VL - 18

SP - 440

EP - 443

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 6

ER -