title: Maternal mortality among HIV-infected pregnant women in Tanzania.
abstract: OBJECTIVE
  To investigate risk factors for maternal mortality among HIV-infected women in Tanzania.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  HIV care and treatment clinics in Dar es Salaam, Tanzania.
  
  
  METHODS
  HIV-infected pregnant women.
  
  
  METHODS
  Data were collected for all patients enrolled in an HIV/AIDS care and treatment program. Between November 2004 and September 2011, there were 18 917 women pregnant at least once during the follow-up. Thirteen percent of these women had more than one pregnancy, with 21 645 pregnancies occurring. Logistic regression was used to explore the predictors of maternal death among these women.
  
  
  METHODS
  Maternal mortality.
  
  
  RESULTS
  During the study period, 363 maternal deaths occurred, giving a maternal mortality ratio of 1729 [95% confidence interval (CI) 1553-1905] per 100 000 live births. Being wasted [odds ratio (OR) 3.38, 95% CI 2.58-4.45] or anemic (OR 2.26, 95% CI 1.70-3.00) was associated with a higher risk of maternal mortality. Women who were initiated on antiretroviral therapy before their pregnancy had a 55% decreased risk of maternal mortality (95% CI 0.29-0.70) compared with women who were not. The risk of maternal mortality decreased with the length of time on antiretroviral therapy during pregnancy, by 8% for each additional month (OR 0.92, 95% CI 0.88-0.96).
  
  
  CONCLUSIONS
  Maternal mortality was high among HIV-infected women. Initiating women on antiretroviral therapy as early as possible and providing nutritional interventions during pregnancy should be considered as means to reduce the maternal mortality among these women.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Matchi
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.forename: Ellen
authors.initials: E
authors.lastname: Hertzmank
authors.forename: David
authors.initials: D
authors.lastname: Sando
authors.forename: Mary M
authors.initials: MM
authors.lastname: Sando
authors.forename: Enju
authors.initials: E
authors.lastname: Liu
authors.forename: Aisa
authors.initials: A
authors.lastname: Muya
authors.forename: Wafaie
authors.initials: W
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D000740:Anemia / Q000401:mortality; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D019247:HIV Wasting Syndrome / Q000401:mortality; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D013997:Time Factors
chemical_list: D044966:Anti-Retroviral Agents; D006454:Hemoglobins
keywords: HIV/AIDS; Maternal mortality; Sub-Saharan Africa; Tanzania; antiretroviral therapy; nutrition status