title: Impaired fertility in HIV-1-infected pregnant women: a clinic-based survey in Abidjan, Côte d'Ivoire, 1997.
abstract: OBJECTIVE
  Differences in fertility among HIV-1-positive and HIV-negative women tested in prenatal clinics were suspected by routine data collection in Abidjan, Côte d'Ivoire. This study was conducted on detailed fertility patterns among women at the same antenatal care centres, in order to assess these differences.
  
  
  METHODS
  The survey was carried out on 1201 consecutive women who agreed to be tested for HIV. Data collected included a detailed account of pregnancies, the time interval between the last two pregnancies, and the health status at the time of the survey. Blood samples were tested for HIV and syphilis with informed consent.
  
  
  RESULTS
  Despite an earlier exposure to pregnancy risk, HIV-1-infected women aged 25 years and above, had, on the average, fewer pregnancies than uninfected women. An analysis of the interval between the last two pregnancies among multigravidae showed that, all things being equal, being HIV-1 positive decreased the risk of being pregnant by 17% (Cox regression, hazard ratio = 0.83, 95% confidence interval (CI): 0.69-0.99). This shift in the occurrence of the last pregnancy was more profound among HIV-1-positive women already at the symptomatic or AIDS stage, than among asymptomatic women.
  
  
  CONCLUSIONS
  These data confirm that women infected by HIV-1 would become pregnant less often than uninfected women, for an equal exposure to the risk of pregnancy. Therefore HIV-1-positive women could be under-represented at antenatal centres. Programmes involving such settings both for epidemiological surveillance and the reduction of mother-to-child transmission should take this observation into account.
authors: Institut de Recherche pour le Dévelopment, Programme Sida, Abidjan, Côte d'Ivoire.
authors: A
authors: A
authors: Desgrées du Loû
authors: P
authors: P
authors: Msellati
authors: A
authors: A
authors: Yao
authors: V
authors: V
authors: Noba
authors: I
authors: I
authors: Viho
authors: R
authors: R
authors: Ramon
authors: C
authors: C
authors: Welffens-Ekra
authors: F
authors: F
authors: Dabis
mesh_terms: D000328:Adult; D007560:Cote d'Ivoire; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology*