Hypertension, preeclampsia and eclampsia among HIV-infected pregnant women from Latin America and Caribbean countries.
OBJECTIVE
To evaluate the incidence of and risk factors for hypertensive disorders in a cohort of HIV-infected pregnant women.


METHODS
Hypertensive disorders (HD) including preeclampsia/eclampsia (PE/E) and pregnancy induced hypertension, and risk factors were evaluated in a cohort of HIV-infected pregnant women from Latin America and the Caribbean enrolled between 2002 and 2009. Only pregnant women enrolled for the first time in the study and delivered at ≥20 weeks gestation were analyzed.


RESULTS
HD were diagnosed in 73 (4.8%, 95% CI: 3.8%-6.0%) of 1513 patients; 35 (47.9%) had PE/E. HD was significantly increased among women with a gestational age-adjusted body mass index (gBMI) ≥25 kg/m(2) (OR = 3.1; 95% CI: 1.9-5.0), hemoglobin (Hg) ≥11 g/dL at delivery (OR = 2.1; 95% CI: 1.2-3.6) and age ≥35 years (OR = 1.8; 95% CI: 1.1-3.2). PE/E was increased among women with a gBMI ≥25 kg/m(2) (OR = 3.0; 95% CI: 1.5-6.0) and Hg ≥11 g/dL at delivery (OR = 2.8; 95% CI: 1.2-6.5). A previous history of PE/E increased the risk of PE/E 6.7 fold (95% CI: 1.8-25.5). HAART before conception was associated with PE/E (OR = 2.3; 95% CI: 1.1-4.9).


CONCLUSIONS
HIV-infected women, with a previous history of PE/E, a gBMI ≥25 kg/m(2), Hg at delivery ≥11 g/dL and in use of HAART before conception are at an increased risk of developing PE/E during pregnancy.
Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: emachado@infolink.com.br.
Elizabeth Stankiewicz
ES
Machado
Westat, Rockville, MD, USA.
Margot R
MR
Krauss
Westat, Rockville, MD, USA.
Karen
K
Megazzini
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Conrado Milani
CM
Coutinho
Irmandade da Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, Brazil.
Regis
R
Kreitchmann
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Victor Hugo
VH
Melo
Laboratório de AIDS e Imunologia Molecular, Fiocruz-IOC & Hospital Geral de Nova Iguaçu, Rio de Janeiro, Brazil.
José Henrique
JH
Pilotto
Infectious Diseases Unit, Dr. Cecilia Grierson Hospital, Buenos Aires, MD, Argentina.
Mariana
M
Ceriotto
Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Cristina B
CB
Hofer
Maternal and Pediatric Infectious Disease Branch, NICHD/NIH, Bethesda, MD, USA.
George K
GK
Siberry
Maternal and Pediatric Infectious Disease Branch, NICHD/NIH, Bethesda, MD, USA.
D Heather
DH
Watts
D000328:Adult; D017691:Caribbean Region / Q000453:epidemiology; D015331:Cohort Studies; D004461:Eclampsia / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D007843:Latin America / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
Eclampsia; HIV-infected women; Hypertensive disorders; Preeclampsia; Pregnancy