title: Pregnancy outcomes in HIV-infected women of advanced maternal age.
abstract: BACKGROUND
  There is limited information on pregnancy outcomes in women with HIV who are of a more advanced maternal age.
  
  
  METHODS
  Data from a national observational study in Italy were used to evaluate the risk of nonelective cesarean section, preterm delivery, low birthweight, major birth defects, and small gestational age-adjusted birthweight according to maternal age (<35 and ≥35 years, respectively).
  
  
  RESULTS
  Among 1,375 pregnancies with live births, 82.4% of deliveries were elective cesarean sections, 15.8% were nonelective cesarean sections, and 1.8% were vaginal deliveries. Rates of nonelective cesarean section were similar among mothers ≥35 and <35 years (odds ratio [OR], 1.22; 95% CI, 0.90-1.65;P = .19). Preterm delivery and low birthweight were significantly more common among women ≥35 years in univariate but not in multivariate analyses. Newborns from women ≥35 and <35 years showed no differences inZ scores of birthweight, with a similar occurrence of birthweight <10th percentile (12.1% vs 12.0%; OR, 1.02; 95% CI, 0.71-1.46;P = .93). The overall rate of birth defects was 3.4% (95% CI, 2.4-4.4), with no differences by maternal age (≥35 years, 3.5%; <35 years, 3.3%; OR, 1.05; 95% CI, 0.56-1.98;P = .88).
  
  
  CONCLUSIONS
  In this study of pregnant women with HIV, older women were at higher risk of some adverse pregnancy outcomes, such as preterm delivery and low birthweight. The association, however, did not persist in multivariable analyses, suggesting a role of some predisposing factors associated with older age.
authors.affiliation: I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Liuzzi
authors.forename: Carmela
authors.initials: C
authors.lastname: Pinnetti
authors.forename: Marco
authors.initials: M
authors.lastname: Floridia
authors.forename: Enrica
authors.initials: E
authors.lastname: Tamburrini
authors.forename: Giulia
authors.initials: G
authors.lastname: Masuelli
authors.forename: Serena
authors.initials: S
authors.lastname: Dalzero
authors.forename: Matilde
authors.initials: M
authors.lastname: Sansone
authors.forename: Vania
authors.initials: V
authors.lastname: Giacomet
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Degli Antoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Meloni
authors.forename: Anna
authors.initials: A
authors.lastname: Maccabruni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alberico
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Portelli
authors.forename: Marina
authors.initials: M
authors.lastname: Ravizza
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D015999:Multivariate Analysis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011256:Pregnancy Outcome