title: Risk of Preeclampsia in Human Immunodeficiency Virus-Infected Pregnant Women.
abstract: To evaluate the risk of preeclampsia in pregnant women with human immunodeficiency virus (HIV).
  
  
  
  This is a 26-year population-based retrospective cohort study. Human immunodeficiency virus-infected pregnant women were compared with a HIV-negative comparison group. The primary outcome was the incidence of preeclampsia. We planned subgroup analysis according to antiretroviral therapy.
  
  
  
  A total of 84,725 women were included in the analysis, of whom 453 were HIV-infected and 84,272 HIV-negative. Of the 453 HIV-infected women, 301 (66.4%) received highly active antiretroviral therapy (HAART group) during pregnancy, whereas 152 (33.6%) did not. After adjusting for confounders, we found that HIV-infected women had a significantly higher risk of preeclampsia (10.2% compared with 4.1%; adjusted odds ratio [OR] 2.68, 95% confidence interval [CI] 1.96-3.64), preeclampsia with severe features (4.0% compared with 2.0%; adjusted OR 2.03, 95% CI 1.26-3.28), early-onset (3.5% compared with 1.4%; adjusted OR 2.50, 95% CI 1.51-4.15) and late-onset preeclampsia (6.6% compared with 2.6%; adjusted OR 2.64, 95% CI 1.82-3.85), and preterm birth at less than 37 weeks of gestation (11.0% compared with 4.7%; adjusted OR 2.50, 95% CI 1.86-3.37) compared with the comparison group. Human immunodeficiency virus-infected women who received HAART had a significantly higher risk of preeclampsia compared with women without HIV (13.0% compared with 4.1%; adjusted OR 3.52, 95% CI 2.51-4.94) and compared with the non-HAART group (13.0% compared with 4.6%; adjusted OR 3.08, 95% CI 1.34-5.07). The non-HAART group had a similar risk compared with women without HIV (4.6% compared with 4.1%; adjusted OR 1.14, 95% CI 0.53-2.44).
  
  
  
  Human immunodeficiency virus-infected women had an increased risk of preeclampsia. Some of this risk seems to be linked to HAART.
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Matilde
authors.initials: M
authors.lastname: Sansone
authors.forename: Laura
authors.initials: L
authors.lastname: Sarno
authors.forename: Gabriele
authors.initials: G
authors.lastname: Saccone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Maruotti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Migliucci
authors.forename: Angela
authors.initials: A
authors.lastname: Capone
authors.forename: Pasquale
authors.initials: P
authors.lastname: Martinelli
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors