Maternal and neonatal outcomes among women with HIV infection and their infants in Malawi

Details

• Alternative Title:
  Int J Gynaecol Obstet
• Personal Author:
  Chevalier, Michelle S. ; King, Caroline C. ; Ellington, Sascha ; Wiener, Jeffrey ; Kayira, Dumbani ; Chasela, Charles S. ; Jamieson, Denise J. ; Kourtis, Athena P.
• Description:
  Objective ; To describe maternal and neonatal morbidity and mortality among women with HIV infection and their infants. ; Methods ; A secondary analysis was undertaken of data obtained in the BAN Study, a trial of postnatal antiretrovirals among pregnant women with HIV infection enrolled in 2004–2010. Mothers and infants had 13 scheduled visits through 48 weeks of follow-up. Serious maternal morbidity and mortality were examined at delivery (n=2791), from delivery to 6 weeks later (n=2369) and from 7 to 48 weeks (n=1980). Neonatal morbidity and mortality were examined (n=2685). ; Results ; Of 2791 deliveries, 169 (6.1%) were by cesarean (153 emergency). Compared with women with vaginal delivery, those with cesarean delivery had lower prenatal HIV viral loads (P=0.016) and increased odds of pre-eclampsia/eclampsia (odds ratio OR 10.8, 95% CI 4.4–26.8). Women with cesarean delivery also had increased odds of serious infection with 14 days of delivery (OR 3.0, 95% CI 1.3–7.4) and severe anemia (grade 3 or 4) by 6 weeks (OR 6.7, 95% CI 2.3–19.1). Infants born by cesarean had increased odds of a low 5-minute Apgar score (OR 8.1, 95% CI 3.5–18.6) and admission to an intensive care unit (OR 5.4, 95% CI 3.7–7.8). ; Conclusion ; Odds of serious maternal and neonatal morbidity were higher after cesarean than vaginal delivery, despite lower maternal viral loads.
• Keywords:
  • Cesarean delivery
  • HIV
  • Malawi
  • Maternal morbidity
  • Mortality
  • Neonatal morbidity
  • Adult
  • Delivery, Obstetric
  • Female
  • HIV Infections
  More +
• Source:
  Int J Gynaecol Obstet. 137(3):282-289
• Pubmed ID:
  28258582
• Pubmed Central ID:
  PMC5419872
• Document Type:
  Journal Article
• Funding:
  D43 TW001039/TW/FIC NIH HHSUnited States/ ; U48DP001944/ACL HHSUnited States/ ; R24 TW007988/TW/FIC NIH HHSUnited States/ ; CC999999/Intramural CDC HHSUnited States/ ; U48DP001944/ACL HHS/ ; R24 HD050924/HD/NICHD NIH HHSUnited States/ ; U48 DP000059/DP/NCCDPHP CDC HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/
• Volume:
  137
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/45566/cdc_45566_DS1.pdf
• File Type:
  [PDF - 154.87 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:74a57f6a05c8495dea8bcbff9492242f8057012a7ccaae544dd3e507907d9fcb