title: Human immunodeficiency virus infection in advanced maternal age gravidas.
abstract: Our study compares perinatal outcomes among HIV(+) versus HIV(-) advanced maternal aged (AMA) women. A retrospective cohort study of AMA deliveries from 2000 to 2009 was performed. HIV(+) (group A) women were compared to temporally matched HIV(-) (group B) women. Demographics, medical comorbidities, HIV treatment, and delivery data were collected. SAS was used for data analysis with p<0.05 considered significant. Seventy-one patients per study group were reviewed; for group A, the mean CD4 count near delivery was 507±363; 75% (34/45) had viral load ≤400 in the third trimester and 58% were on a protease inhibitor regimen. HIV(+) women had significantly higher preterm delivery (PTD) <37 weeks (A: 40.85%, B: 16.90%, p=0.0016). Logistic regression performed revealed that the odds of PTD was 2.83 (CI 1.22-6.54) for HIV(+) and 4.02 (CI 1.27-12.72) for drug use independent of other factors. The pathophysiology of PTD among HIV(+) AMA women warrants prospective examination to better define the causal relationship.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, UMDNJ-New Jersey Medical School, Newark, New Jersey, USA. kbrown11@nshs.edu
authors.forename: Kelecia
authors.initials: K
authors.lastname: Brown
authors.forename: Bart
authors.initials: B
authors.lastname: Holland
authors.forename: Claudia
authors.initials: C
authors.lastname: Mosquera
authors.forename: Charmane
authors.initials: C
authors.lastname: Calilap
authors.forename: Arlene
authors.initials: A
authors.lastname: Bardeguez
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data; D016015:Logistic Models; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology*; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D019562:Viral Load