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Maternal and neonatal outcomes among women with HIV infection and their infants in Malawi
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6 2017
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Source: Int J Gynaecol Obstet. 137(3):282-289
[PDF-154.87 KB]
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Alternative Title:Int J Gynaecol Obstet
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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.
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Pubmed ID:28258582
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Pubmed Central ID:PMC5419872
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