Pregnancy in HIV-infected teenagers in London.
OBJECTIVE
The aim of the study was to describe pregnancies in HIV-infected teenagers.


METHODS
A review of the case notes of HIV-infected pregnant teenagers aged 13-19 years from 12 London hospitals was carried out for the period 2000-2007.


RESULTS
There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started post-conception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (<37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again.


CONCLUSIONS
Obstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed.
Elgalib
A
A
Guy's and St Thomas' NHS Foundation Trust, London, UK. alielgalib@yahoo.co.uk
Hegazi
A
A
Samarawickrama
A
A
Roedling
S
S
Tariq
S
S
Draeger
E
E
Hemelaar
J
J
Rathnayaka
T
T
Azwa
A
A
Hawkins
D
D
Edwards
S
S
Perez
K
K
Russell
J
J
Wood
C
C
Poulton
M
M
Shah
R
R
Noble
H
H
Rodgers
M
M
Taylor
G P
GP
Anderson
J
J
de Ruiter
A
A
D000028:Abortion, Induced / Q000706:statistics & numerical data; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D008017:Life Expectancy; D008131:London / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D055815:Young Adult