Repeat pregnancy in women with HIV infection in Latin America and the Caribbean.
Intended and unintended pregnancies occur frequently among human immunodeficiency virus (HIV)-infected women. We evaluated the occurrence of repeat pregnancy and characteristics associated with this outcome among HIV-infected women in Latin America and the Caribbean who were participating in the National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI). Of the 1342 HIV-infected pregnant women enrolled in NISDI, 124 (9.2%) had one or more repeat pregnancies on study. Median time between the index delivery and date of conception of the subsequent pregnancy was 1.4 years (range 0.1-5.7). Younger age (odds ratio [OR] = 1.07, 95% confidence interval [CI]: 1.04-1.11 per one year decrease in age), hospitalization during the index pregnancy or up to six months post-partum [OR = 2.0, 95% CI: 1.2-3.4], and poor index pregnancy outcome (stillbirth or spontaneous/therapeutic abortion; OR = 3.4, 95% CI: 1.4-8.4) were associated with increased occurrence of repeat pregnancy in multivariable analysis. Among women with repeat pregnancies, the proportion receiving antiretroviral treatment (vs. prophylaxis) increased from 39.4% at the time of the index pregnancy to 81.8% at the time of the repeat pregnancy (p < 0.001). These results can help identify women most likely to benefit from reproductive counseling in order to assist with healthy pregnancy planning and prevention of unintended pregnancies.
a Irmandade da Santa Casa de Misericordia de Porto Alegre , Professor Annes Dias 285, Porto Alegre , RS 90020090 , Brazil.
Regis
R
Kreitchmann
b Westat , 1600 Research Blvd, Rockville , MD 20850 , USA.
Karen
K
Megazzini
c School of Medicine , Federal University of Minas Gerais , Av. Alfredo Balena 190, 2th floor, Belo Horizonte , Brazil.
Victor Hugo
VH
Melo
a Irmandade da Santa Casa de Misericordia de Porto Alegre , Professor Annes Dias 285, Porto Alegre , RS 90020090 , Brazil.
Débora
D
Fernandes Coelho
d U.S. Department of State , Washington , DC , USA.
D Heather
DH
Watts
b Westat , 1600 Research Blvd, Rockville , MD 20850 , USA.
Margot
M
Krauss
e Hospital Federal dos Servidores do Estado , Rua Sacadura Cabral, 178, Anexo IV, 4 andar, Rio de Janeiro , RJ - CEP 20221903 , Brazil.
Maria Isabel
MI
Gouvea
f Faculty of Medicine of Ribeirão Preto , University of São Paulo , Avenida Bandeirantes 3900, Ribeirão Preto, São Paulo , Brazil.
Geraldo
G
Duarte
g HIV Unit , Hospital General de Agudos Jose Maria Ramos Mejia , Urquiza 609, Pabellon de Clinicas, 2 Piso, C1221ADC Buenos Aires , Argentina.
Marcelo H
MH
Losso
h Maternal Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) , National Institutes of Health , 6100 Executive Blvd., Room 4B11H, Bethesda , MD 20892-7510 , USA.
George K
GK
Siberry
D000293:Adolescent; D000328:Adult; D017691:Caribbean Region / Q000453:epidemiology; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007843:Latin America / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D049168:Pregnancy, Unplanned; D055815:Young Adult
HIV; Latin America; predictors of repeat pregnancy; pregnancy