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:
  Adult Cesarean Delivery Delivery, Obstetric Female HIV HIV Infections Humans Infant Infant, Newborn Infant Mortality Malawi Maternal Morbidity Maternal Mortality Morbidity Mortality Neonatal Morbidity Perinatal Mortality Pregnancy Pregnancy Complications, Infectious Pregnancy Outcome Young Adult

  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
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:74a57f6a05c8495dea8bcbff9492242f8057012a7ccaae544dd3e507907d9fcb
• Download URL:
  https://stacks.cdc.gov/view/cdc/45566/cdc_45566_DS1.pdf
• File Type:
  [PDF - 154.87 KB ]