Human immunodeficiency virus infection is a risk factor for adverse perinatal outcome

The purpose of this study was to examine the relationship between maternal human immunodeficiency virus infection and adverse perinatal outcomes.

A retrospective cohort study was conducted in a population of pregnant women who were delivered in a large inner-city hospital between January 1, 1988, and December 31, 1995. The study population consisted of 563 women who were human immunodeficiency virus seropositive and 2252 control subjects who were human immunodeficiency virus seronegative. Results were analyzed with descriptive statistics, chi2 tests, and logistic regression to adjust for potential confounders.

Women who were seropositive were more likely than control subjects to deliver low birth weight infants (29.3% vs 16.3%; odds ratio, 2.11; 95% CI, 1.68-2.64), preterm infants (28.9% vs 18.2%; odds ratio, 1.83; 95% CI, 1.45-2.38), and intrauterine growth-restricted infants (16.5% vs 10.6%; odds ratio, 1.66; 95% CI, 1.26-2.19). They were also more likely to have perinatal deaths (11.5% vs 8.3% odds ratio, 1.41; 95% CI, 1.03-1.95). The risk of fetal malformations, fetal distress, and route of delivery were similar between the groups. After race, parity, alcohol use, prenatal care, diabetes mellitus, hypertension, percent ideal body weight, and sexually transmitted diseases were controlled with logistic regression, the increased risk of low birth weight (adjusted odds ratio, 1.45; 95% CI, 1.14-1.86) and preterm delivery (adjusted odds ratio, 1.32; 95% CI, 1.04-1.70) persisted.

Parturients in our inner-city hospital who were infected with human immunodeficiency virus are at increased risk for delivery of low-birth-weight and premature infants.