| The objectives of the study were to determine the associations between infection and HIV-related factors, and adverse obstetric outcomes.; A total of 314 HIV-infected and 628 uninfected pregnant women, matched by age and parity, were followed prospectively throughout their pregnancies at Siriraj hospital, Thailand. Incidence of adverse outcomes in the mothers and their infants were compared between the 2 groups. Among HIV-infected women, CD4+ T-lymphocyte count and viral load were determined and then examined for their associations with the adverse outcomes.; HIV infection was independently associated with increased risk of sexually transmitted disease (STD), urinary tract infections (UTI), and postpartum complications (RH 5.59, 95% CI 3.87–8.07; 2.07, 95% CI 1.01–4.20; and adjusted OR 5.21, 95% CI 2.58–10.54, respectively). Medical, obstetric, and neonatal complications were not affected by HIV infection. Infants of HIV-infected mothers were significantly smaller at birth in terms of birth weight and other anthropometric measurements. Maternal HIV infection was independently associated with increased risk of low birth weight (LBW) infants (adjusted OR 1.98, 95% CI 1.14–3.45), but not with small for gestational age (SGA) or preterm delivery.; Low maternal CD4+ T-lymphocyte count (<200 cells/uL) was independently associated with increased risk of STD infections and postpartum complications (RH 2.27, 95% Cl 1.33–3.87; and adjusted OR 2.39, 95% Cl 1.14–5.00, respectively), but not UTI. Maternal viral load level in the highest quartile (>76,800 copies/mL) was independently associated with increased risk of LBW (adjusted OR 4.76, 95% Cl 1.47–15.35), but not SGA and preterm delivery. Neither maternal CD4+ T-lymphocyte count nor viral load was associated with other obstetric and neonatal complications.; The observed associations support the possible additional risks of HIV infection on adverse obstetric outcomes other than perinatal HIV transmission, particularly infectious complications and inappropriate fetal growth. Interventions should be developed to improve and minimize these adverse outcomes for better prognosis of HIV-infected women and their newborns. |
