title: Obstetric and perinatal complications in HIV-infected women. Analysis of a cohort of 167 pregnancies between 1997 and 2003.
abstract: BACKGROUND
  The unquestionable benefit of antiretroviral therapy in reducing the rate of mother-to-child transmission can be lessened by potential maternal or neonatal toxicity.
  
  
  OBJECTIVE
  To analyze obstetric and perinatal complications in a cohort of HIV-infected pregnant women and their relationship with maternal antiretroviral therapy.
  
  
  METHODS
  One hundred and sixty-seven HIV-infected pregnant women who delivered at Hospital Universitario La Paz, Madrid, Spain between January 1997 and December 2003.
  
  
  METHODS
  Data on the clinical and epidemiological characteristics of HIV-infected patients, previous and current antiretroviral therapy, gestational diabetes mellitus, length of pregnancy, mode of delivery, and weight of the newborn were collected. Pregnancy outcomes were compared with those of all the pregnant women attended at our hospital.
  
  
  METHODS
  Gestational diabetes mellitus, premature delivery, and low birth weight.
  
  
  RESULTS
  Gestational diabetes mellitus was diagnosed in 8.9% of patients. All the cases of gestational diabetes were in the combined antiretroviral therapy group, and the majority were receiving triple antiretroviral therapy with a protease inhibitor. The risk of developing this pathology was greater among women receiving antiretroviral therapy prior to pregnancy. The premature delivery rate was 29% and the low birth weight rate was 28%.
  
  
  CONCLUSIONS
  Gestational diabetes mellitus is more common in HIV-infected women than in the general population and is related to combined antiretroviral therapy, especially the use of protease inhibitors, which suggests the need for close follow-up during pregnancy in HIV-infected patients. Nevertheless, the adverse perinatal consequences observed were more related to maternal factors than to antiretroviral therapy.
authors.affiliation: Department of Gynecology and Obstetrics, Maternity Hospital, Madrid, Spain.
authors.forename: Covadonga
authors.initials: C
authors.lastname: Martí
authors.forename: Jose M
authors.initials: JM
authors.lastname: Peña
authors.forename: Isabel
authors.initials: I
authors.lastname: Bates
authors.forename: Rosario
authors.initials: R
authors.lastname: Madero
authors.forename: Isabel
authors.initials: I
authors.lastname: de José
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Pallardo
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: Juan
authors.initials: J
authors.lastname: Gonzalez-Garcia
authors.forename: Antonio
authors.initials: A
authors.lastname: Gonzalez
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Vazquez
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000517:prevention & control; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D011480:Protease Inhibitors