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Published on: October 12, 2018
Pregnancy outcomes in young women with perinatally acquired human immunodeficiency virus-1
Shauna F Williams1, Megan H Keane-Tarchichi, Linda Bettica
1Department of Obstetrics, Gynecology, and Women's Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07101, USA.
Insights
Pregnancy outcomes for adolescents with perinatal human immunodeficiency virus (HIV) infection were reviewed. Despite complications, perinatal outcomes were favorable, with only one infant infected with HIV.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Pediatrics
Background:
- Perinatal human immunodeficiency virus (HIV) infection presents unique challenges in adolescent pregnancies.
- Understanding pregnancy and neonatal outcomes is crucial for optimizing care.
Purpose of the Study:
- To review pregnancy and neonatal outcomes among perinatally HIV-infected pregnant adolescents at a single institution.
- To identify common comorbidities and obstetrical complications in this population.
Main Methods:
- Retrospective review of maternal and neonatal records for 10 perinatally HIV-infected adolescents (1997-2007).
- Data abstracted included demographics, HIV viral load and CD4 counts, antiretroviral therapy, comorbidities, pregnancy outcomes, and neonatal HIV status.
Main Results:
- The median age at first pregnancy was 18.5 years; 80% had cervical dysplasia/STIs, and 70% had hematologic abnormalities.
- Common complications included preterm delivery (31%) and preeclampsia (23%). Cesarean delivery rate was 62%, primarily for HIV indication.
- One infant (10%) acquired HIV infection; all infants were born alive.
Conclusions:
- Perinatal outcomes for adolescents with HIV were favorable despite high rates of STIs, cesarean delivery, preterm birth, and hypertensive disorders.
- Effective management strategies can lead to positive maternal and neonatal health outcomes in this population.
Objective:
The objective of the study was to review pregnancy and neonatal outcomes among perinatally infected pregnant patients at our institution.
Study Design:
A retrospective review of maternal and neonatal records for all 10 perinatally infected adolescents between 1997 and 2007 was performed. Demographics, CD4 and viral load, antiretroviral treatment, medical comorbidities, pregnancy outcomes, and neonatal human immunodeficiency virus (HIV) status were abstracted.
Results:
The median age at first pregnancy was 18.5 years and 70% were African American. The most common comorbidities were hematologic abnormalities (70%) and cervical dysplasia/sexually transmitted infections (STIs) (80%). Initial median CD4 and viral load were 317 cells/mm(3) and 8780 copies/mL, respectively. The median gestational age at delivery was 38 weeks. The most common obstetrical complications were preeclampsia (23%) and premature rupture of membranes/preterm delivery (31%). The cesarean delivery (CD) rate was 62%, with HIV as the indication in 75%. All infants were born alive; 1 was HIV infected.
Conclusion:
Despite high rates of STIs, CD, preterm delivery, and hypertensive disorders, perinatal outcomes were favorable.
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