Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: A cohort study

R. Kreitchmann; S. X. Li; V. H. Melo; D. Fernandes Coelho; D. H. Watts; E. Joao; C. M. Coutinho; J. O. Alarcon; G. K. Siberry

doi:10.1111/1471-0528.12680

Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: A cohort study

R. Kreitchmann, S. X. Li, V. H. Melo, D. Fernandes Coelho, D. H. Watts, E. Joao, C. M. Coutinho, J. O. Alarcon, G. K. Siberry

Research output: Contribution to journal › Article › peer-review

31 Scopus citations

Abstract

Results: Among 1512 women, 1.9% (95% confidence interval, 95% CI, 1.3-2.7) of singleton pregnancies resulted in a stillbirth and 32.9% (95% CI 30.6-35.4) had at least one adverse pregnancy outcome. Of 1483 singleton live births, 19.8% (95% CI 17.8-21.9) were PT, 14.2% (95% CI 12.5-16.1) were LBW, 12.6% (95% CI 10.9-14.4) were SGA, and 0.4% (95% CI 0.2-0.9) of infants died within 28 days of birth. Multivariable logistic regression modelling indicated that the following risk factors increased the probability of having one or more adverse pregnancy outcomes: lower maternal body mass index at delivery (odds ratio, OR, 2.2; 95% CI 1.4-3.5), hospitalisation during pregnancy (OR 3.3; 95% CI 2.0-5.3), hypertension during pregnancy (OR 2.7; 95% CI 1.5-4.8), antiretroviral use at conception (OR 1.4; 95% CI 1.0-1.9), and tobacco use during pregnancy (OR 1.7; 95% CI 1.3-2.2). The results of fitting multivariable logistic regression models for PT, LBW, SGA, and SB are also reported.

Population: Women infected with HIV enrolled in the Perinatal (2002-2007) and the Longitudinal Study in Latin American Countries (LILAC; 2008-2012) studies of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).

Methods: Frequencies of adverse pregnancy outcomes assessed among pregnancies. Risk factors investigated by logistic regression analysis.

Main: outcome measures Adverse pregnancy outcomes, including preterm delivery (PT), low birthweight (LBW), small for gestational age (SGA), stillbirth (SB), and neonatal death.

Conclusions: Women infected with HIV had a relatively high occurrence of adverse pregnancy outcomes, and some maternal risk factors were associated with these adverse pregnancy outcomes. Interventions targeting modifiable risk factors should be evaluated further.

Objective: To examine maternal characteristics associated with adverse pregnancy outcomes among women infected with HIV.

Design: Prospective cohort study.

Setting: Multiple sites in Latin America and the Caribbean.

Original language	English
Pages (from-to)	1501-1508
Number of pages	8
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	121
Issue number	12
DOIs	https://doi.org/10.1111/1471-0528.12680
State	Published - 1 Nov 2014

Bibliographical note

Publisher Copyright:
© 2014 Royal College of Obstetricians and Gynaecologists.

Keywords

HIV
Latin America
Pregnancy
Pregnancy outcomes
Prematurity

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10.1111/1471-0528.12680

Cite this

Kreitchmann, R., Li, S. X., Melo, V. H., Fernandes Coelho, D., Watts, D. H., Joao, E., Coutinho, C. M., Alarcon, J. O., & Siberry, G. K. (2014). Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: A cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 121(12), 1501-1508. https://doi.org/10.1111/1471-0528.12680

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abstract = "Results: Among 1512 women, 1.9% (95% confidence interval, 95% CI, 1.3-2.7) of singleton pregnancies resulted in a stillbirth and 32.9% (95% CI 30.6-35.4) had at least one adverse pregnancy outcome. Of 1483 singleton live births, 19.8% (95% CI 17.8-21.9) were PT, 14.2% (95% CI 12.5-16.1) were LBW, 12.6% (95% CI 10.9-14.4) were SGA, and 0.4% (95% CI 0.2-0.9) of infants died within 28 days of birth. Multivariable logistic regression modelling indicated that the following risk factors increased the probability of having one or more adverse pregnancy outcomes: lower maternal body mass index at delivery (odds ratio, OR, 2.2; 95% CI 1.4-3.5), hospitalisation during pregnancy (OR 3.3; 95% CI 2.0-5.3), hypertension during pregnancy (OR 2.7; 95% CI 1.5-4.8), antiretroviral use at conception (OR 1.4; 95% CI 1.0-1.9), and tobacco use during pregnancy (OR 1.7; 95% CI 1.3-2.2). The results of fitting multivariable logistic regression models for PT, LBW, SGA, and SB are also reported.Population: Women infected with HIV enrolled in the Perinatal (2002-2007) and the Longitudinal Study in Latin American Countries (LILAC; 2008-2012) studies of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).Methods: Frequencies of adverse pregnancy outcomes assessed among pregnancies. Risk factors investigated by logistic regression analysis.Main: outcome measures Adverse pregnancy outcomes, including preterm delivery (PT), low birthweight (LBW), small for gestational age (SGA), stillbirth (SB), and neonatal death.Conclusions: Women infected with HIV had a relatively high occurrence of adverse pregnancy outcomes, and some maternal risk factors were associated with these adverse pregnancy outcomes. Interventions targeting modifiable risk factors should be evaluated further.Objective: To examine maternal characteristics associated with adverse pregnancy outcomes among women infected with HIV.Design: Prospective cohort study.Setting: Multiple sites in Latin America and the Caribbean.",

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year = "2014",

month = nov,

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doi = "10.1111/1471-0528.12680",

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volume = "121",

pages = "1501--1508",

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Kreitchmann, R, Li, SX, Melo, VH, Fernandes Coelho, D, Watts, DH, Joao, E, Coutinho, CM, Alarcon, JO & Siberry, GK 2014, 'Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: A cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 121, no. 12, pp. 1501-1508. https://doi.org/10.1111/1471-0528.12680

TY - JOUR

T1 - Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean

T2 - A cohort study

AU - Kreitchmann, R.

AU - Li, S. X.

AU - Melo, V. H.

AU - Fernandes Coelho, D.

AU - Watts, D. H.

AU - Joao, E.

AU - Coutinho, C. M.

AU - Alarcon, J. O.

AU - Siberry, G. K.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Results: Among 1512 women, 1.9% (95% confidence interval, 95% CI, 1.3-2.7) of singleton pregnancies resulted in a stillbirth and 32.9% (95% CI 30.6-35.4) had at least one adverse pregnancy outcome. Of 1483 singleton live births, 19.8% (95% CI 17.8-21.9) were PT, 14.2% (95% CI 12.5-16.1) were LBW, 12.6% (95% CI 10.9-14.4) were SGA, and 0.4% (95% CI 0.2-0.9) of infants died within 28 days of birth. Multivariable logistic regression modelling indicated that the following risk factors increased the probability of having one or more adverse pregnancy outcomes: lower maternal body mass index at delivery (odds ratio, OR, 2.2; 95% CI 1.4-3.5), hospitalisation during pregnancy (OR 3.3; 95% CI 2.0-5.3), hypertension during pregnancy (OR 2.7; 95% CI 1.5-4.8), antiretroviral use at conception (OR 1.4; 95% CI 1.0-1.9), and tobacco use during pregnancy (OR 1.7; 95% CI 1.3-2.2). The results of fitting multivariable logistic regression models for PT, LBW, SGA, and SB are also reported.Population: Women infected with HIV enrolled in the Perinatal (2002-2007) and the Longitudinal Study in Latin American Countries (LILAC; 2008-2012) studies of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).Methods: Frequencies of adverse pregnancy outcomes assessed among pregnancies. Risk factors investigated by logistic regression analysis.Main: outcome measures Adverse pregnancy outcomes, including preterm delivery (PT), low birthweight (LBW), small for gestational age (SGA), stillbirth (SB), and neonatal death.Conclusions: Women infected with HIV had a relatively high occurrence of adverse pregnancy outcomes, and some maternal risk factors were associated with these adverse pregnancy outcomes. Interventions targeting modifiable risk factors should be evaluated further.Objective: To examine maternal characteristics associated with adverse pregnancy outcomes among women infected with HIV.Design: Prospective cohort study.Setting: Multiple sites in Latin America and the Caribbean.

AB - Results: Among 1512 women, 1.9% (95% confidence interval, 95% CI, 1.3-2.7) of singleton pregnancies resulted in a stillbirth and 32.9% (95% CI 30.6-35.4) had at least one adverse pregnancy outcome. Of 1483 singleton live births, 19.8% (95% CI 17.8-21.9) were PT, 14.2% (95% CI 12.5-16.1) were LBW, 12.6% (95% CI 10.9-14.4) were SGA, and 0.4% (95% CI 0.2-0.9) of infants died within 28 days of birth. Multivariable logistic regression modelling indicated that the following risk factors increased the probability of having one or more adverse pregnancy outcomes: lower maternal body mass index at delivery (odds ratio, OR, 2.2; 95% CI 1.4-3.5), hospitalisation during pregnancy (OR 3.3; 95% CI 2.0-5.3), hypertension during pregnancy (OR 2.7; 95% CI 1.5-4.8), antiretroviral use at conception (OR 1.4; 95% CI 1.0-1.9), and tobacco use during pregnancy (OR 1.7; 95% CI 1.3-2.2). The results of fitting multivariable logistic regression models for PT, LBW, SGA, and SB are also reported.Population: Women infected with HIV enrolled in the Perinatal (2002-2007) and the Longitudinal Study in Latin American Countries (LILAC; 2008-2012) studies of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI).Methods: Frequencies of adverse pregnancy outcomes assessed among pregnancies. Risk factors investigated by logistic regression analysis.Main: outcome measures Adverse pregnancy outcomes, including preterm delivery (PT), low birthweight (LBW), small for gestational age (SGA), stillbirth (SB), and neonatal death.Conclusions: Women infected with HIV had a relatively high occurrence of adverse pregnancy outcomes, and some maternal risk factors were associated with these adverse pregnancy outcomes. Interventions targeting modifiable risk factors should be evaluated further.Objective: To examine maternal characteristics associated with adverse pregnancy outcomes among women infected with HIV.Design: Prospective cohort study.Setting: Multiple sites in Latin America and the Caribbean.

KW - HIV

KW - Latin America

KW - Pregnancy

KW - Pregnancy outcomes

KW - Prematurity

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U2 - 10.1111/1471-0528.12680

DO - 10.1111/1471-0528.12680

M3 - Artículo

C2 - 24602102

AN - SCOPUS:84914670299

SN - 1470-0328

VL - 121

SP - 1501

EP - 1508

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 12

ER -

Predictors of adverse pregnancy outcomes in women infected with HIV in Latin America and the Caribbean: A cohort study

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Keywords

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