title: Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV.
abstract: OBJECTIVE
  To determine frequency and outcomes of pregnancy in US women with HIV before and after introduction of highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Prospective cohort study at six US centers.
  
  
  METHODS
  HIV seropositive and at-risk seronegative women reported pregnancy outcomes at 6-month intervals during the period 1 October 1994 to 31 March 2002. Outcomes were tabulated and pregnancy rates calculated. Logistic regression defined outcome correlates.
  
  
  RESULTS
  Pregnancy rates were 7.4 and 15.2 per 100 person-years in seropositive and seronegative women, respectively (P < 0.0001). Among seropositives, 119 (36%) pregnancies ended in live birth, six (2%) in stillbirth, 126 (36%) in abortion, 83 (24%) in miscarriage, 16 (5%) in ectopic pregnancy, and two (1%) in other outcomes (P = nonsignificant versus seronegatives). Independent baseline correlates of conception in seropositives included younger age [odds ratio (OR), 1.20; 95% confidence interval (CI), 1.16-1.23], prior abortion (OR, 1.79; 95% CI, 1.25-2.63), lower HIV RNA levels (OR, 1.30; 95% CI, 1.10-1.54 for each log decrease), and being unmarried (OR, 1.59; 95% CI, 1.02-2.44). Baseline antiretroviral use at baseline was linked to lower conception risk (OR, 0.34; 95% CI, 0.49-0.98 for mono- or combination therapy; OR, 0.34; 95% CI, 0.03-4.28 for HAART). Abortion was less likely during the HAART era, (OR, 0.68; 95% CI, 0.35-1.33 during the early HAART era; OR, 0.46; 95% CI, 0.23-0.90 during the later HAART era, compared with before HAART).
  
  
  CONCLUSIONS
  Women with HIV were less likely to conceive than at-risk uninfected women, but pregnancy outcomes were similar. Abortion became less common after the introduction of HAART.
authors.affiliation: Department of Obstetrics and Gynecology, Southern Illinois University, Springfield, Illinois, 62794-9640, USA.
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Gayle
authors.initials: G
authors.lastname: Springer
authors.forename: Lisa
authors.initials: L
authors.lastname: Jacobson
authors.forename: Heather
authors.initials: H
authors.lastname: Watts
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Abner
authors.initials: A
authors.lastname: Korn
authors.forename: Helen
authors.initials: H
authors.lastname: Cejtin
authors.forename: Alice
authors.initials: A
authors.lastname: Stek
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: Julie
authors.initials: J
authors.lastname: Schmidt
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D005306:Fertilization; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D018873:Pregnancy Rate; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology