title: Glucose plasma levels and pregnancy outcomes in women with HIV.
abstract: BACKGROUND
  There is limited information on the relation between glucose levels in pregnancy and adverse perinatal outcomes in HIV-infected pregnant women.
  
  
  OBJECTIVE
  To evaluate the potential impact of fasting glucose levels on pregnancy outcomes in a large sample of pregnant women with HIV from a national study, adjusting for potential confounders.
  
  
  METHODS
  Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. The main outcomes evaluated in univariate and multivariable analyses were birthweight for gestational age>90th percentile (large for gestational age [LGA]), nonelective cesarean delivery, and preterm delivery. Glucose measurements were considered both as continuous and as categorical variables, following the HAPO study definition.
  
  
  RESULTS
  Overall, 1,032 cases were eligible for the analysis. In multivariable analyses, a birthweight>90th percentile was associated with increasing fasting plasma glucose levels (adjusted odds ratio [AOR] per unitary (mg/dL) increase, 1.04; 95% CI, 1.01-1.06; P=.005), a higher body mass index, and parity of 1 or higher. A lower risk of LGA was associated with smoking and African ethnicity. A higher fasting plasma glucose category was significantly associated with LGA occurrence, and AORs for the glucose categories of 90-94 mg/ dL and 95-99 mg/dL were 3.34 (95% CI, 1.09-10.22) and 6.26 (95% CI, 1.82-21.58), respectively. Fasting plasma glucose showed no association with nonelective cesarean section [OR per unitary increase, 1.00; 95% CI, 0.98-1.02] or preterm delivery [OR per unitary increase, 1.00; 95% CI, 0.99-1.02].
  
  
  CONCLUSIONS
  In pregnant women with HIV, glucose values below the threshold usually defining hyperglycemia are associated with an increased risk of delivering LGA infants. Other conditions may independently contribute to adverse perinatal outcomes in women with HIV and should be considered to identify pregnancies at risk.
authors.affiliation: Department of Obstetrics and Gynaecology, S. Giovanni di Dio Hospital, Cagliari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Meloni
authors.forename: Marco
authors.initials: M
authors.lastname: Floridia
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alberico
authors.forename: Enrica
authors.initials: E
authors.lastname: Tamburrini
authors.forename: Carmela
authors.initials: C
authors.lastname: Pinnetti
authors.forename: Anna
authors.initials: A
authors.lastname: Bucceri
authors.forename: Giulia
authors.initials: G
authors.lastname: Masuelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Viganò
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Liuzzi
authors.forename: Anna Degli
authors.initials: AD
authors.lastname: Antoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Marocco
authors.forename: Serena
authors.initials: S
authors.lastname: Dalzero
authors.forename: Marina
authors.initials: M
authors.lastname: Ravizza
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology
chemical_list: D001786:Blood Glucose