title: The relationship of pregnancy to human immunodeficiency virus disease progression.
abstract: OBJECTIVE
  This study was undertaken to determine the effect of pregnancy on progression of human immunodeficiency virus (HIV) disease.
  
  
  METHODS
  We compared the immunologic, clinical, and virologic courses of 953 women who had no additional pregnancy after their index pregnancy, with the courses of 329 women who had a second pregnancy subsequent to their index pregnancy. Baseline variables included use of antiretroviral therapy, and CD4 and HIV RNA values. A linear spline growth curve model was used to describe trajectories of variables. The Cox proportional hazards model was used to assess selected covariates on the time to development of clinical class C events or death.
  
  
  RESULTS
  Women with repeat pregnancies were less likely to be on antiretroviral therapy at baseline and had a higher CD4% count immediately after their first delivery. The average trajectory of CD4 values in the one-pregnancy group was almost identical to the average trajectory in the repeat pregnancy group. RNA levels in the single-pregnancy group started higher but ended lower than in the second-pregnancy group, although slope differences were modest. There were no significant differences in time to class C events, although women in the repeat-pregnancy group tended to survive longer.
  
  
  CONCLUSIONS
  Repeat pregnancies do not have significant effects on the course of HIV disease.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center and SUNY Downstate, Brooklyn, New York 11219, USA. Hminkoff@maimonidesmed.org
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Ron
authors.initials: R
authors.lastname: Hershow
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Margaret
authors.initials: M
authors.lastname: Frederick
authors.forename: Irene
authors.initials: I
authors.lastname: Cheng
authors.forename: Ruth
authors.initials: R
authors.lastname: Tuomala
authors.forename: Jane
authors.initials: J
authors.lastname: Pitt
authors.forename: Carmen D
authors.initials: CD
authors.lastname: Zorrilla
authors.forename: Hunter
authors.initials: H
authors.lastname: Hammill
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Adeniyi-Jones
authors.forename: Bruce
authors.initials: B
authors.lastname: Thompson
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D036861:Delivery, Obstetric; D005260:Female; D020073:Gravidity; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D016019:Survival Analysis
chemical_list: D012367:RNA, Viral