title: Pregnancy is not associated with the progression of HIV disease in women attending an HIV outpatient program.
abstract: The objective of this study was to determine whether pregnancy is associated with an acceleration of human immunodeficiency virus (HIV) disease progression in women who have a pregnancy while HIV infected. A retrospective review of all women aged 15-35 years who attended an HIV outpatient program from January 1989 through August 1995, was undertaken. The 192 women who had a term pregnancy after testing positive for HIV were compared with 164 women who were not pregnant during the same period. The main outcome measures were death, the occurrence of a first acquired immunodeficiency syndrome (AIDS)-defining condition, or a condition indicative of symptomatic HIV. Disease progression was assessed using the Kaplan-Meier method and multivariate proportional hazards models. Compared with nonpregnant women, women with a term pregnancy were significantly more likely to be African-American (88% vs. 78%, p < 0.05), younger than 22 years of age (51 % vs. 11%, p < 0.001), and to have entered the clinic with a higher median CD4 count (519 vs. 433 cells/microl, p < 0.001). After adjusting for entry CD4 count and other factors, pregnancy was not associated with progression to any of the study outcomes. Thus, in women attending a publicly funded clinic, pregnancy does not appear to accelerate the progression of HIV disease.
authors.affiliation: Department of Biostatistics and Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
authors.forename: R
authors.initials: R
authors.lastname: Bessinger
authors.forename: R
authors.initials: R
authors.lastname: Clark
authors.forename: P
authors.initials: P
authors.lastname: Kissinger
authors.forename: J
authors.initials: J
authors.lastname: Rice
authors.forename: S
authors.initials: S
authors.lastname: Coughlin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000554:Ambulatory Care Facilities; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012189:Retrospective Studies