Perinatal outcomes in HIV positive pregnant women with concomitant sexually transmitted infections.
OBJECTIVE
To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs) are at increased risk of adverse perinatal and neonatal outcomes.


METHODS
We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB), postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders.


RESULTS
HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR) 2.11, 95% confidence interval [CI] 1.12-3.97). After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01-3.78).


CONCLUSIONS
HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.
Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Building, 4th Floor, Atlanta, GA 30303, USA.
Erin
E
Burnett
Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Building, 4th Floor, Atlanta, GA 30303, USA.
Tammy L
TL
Loucks
Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Building, 4th Floor, Atlanta, GA 30303, USA.
Michael
M
Lindsay
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005845:Georgia; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications*