Obstetric and perinatal complications in HIV-infected women. Analysis of a cohort of 167 pregnancies between 1997 and 2003.
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.
Martí
Covadonga
C
Department of Gynecology and Obstetrics, Maternity Hospital, Madrid, Spain.
Peña
Jose M
JM
Bates
Isabel
I
Madero
Rosario
R
de José
Isabel
I
Pallardo
Luis Felipe
LF
Arribas
Jose Ramón
JR
Gonzalez-Garcia
Juan
J
Gonzalez
Antonio
A
Vazquez
Juan José
JJ
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
D019380:Anti-HIV Agents; D011480:Protease Inhibitors