title: Pregnancy rate and birth outcomes among women receiving antiretroviral therapy in Burkina Faso: a retrospective cohort study.
abstract: BACKGROUND
  In Sub-Saharan Africa, few studies reported pregnancy incidence and outcomes in women taking antiretroviral therapy (ART). This survey aims to estimate the incidence and outcomes of pregnancy in a cohort of HIV positive women initiating ART in Bobo-Dioulasso, Burkina Faso.
  
  
  METHODS
  We carried out a retrospective cohort study. We selected women in childbearing age initiating ART and followed up in Bobo-Dioulasso teaching hospital between January 2005 and June 2011. The incidence of pregnancies during follow-up was calculated. Childbirth was defined by the expulsion of a fetus after 22 weeks of amenorrhea. Before this term, it is an abortion. Childbirth is said premature if it occurs before 37 weeks of gestation, to term if it occurs between the 38th and the 42nd week. The annual age-standardized fertility rates were calculated using the baseline population from the 2010 demographic and health survey (DHS) in Burkina Faso.
  
  
  RESULTS
  A total of 1,763 women of childbearing age under ART were included in the study. They ranged between 18 and 48 years old with a median of 35 years old. A total of 222 pregnancies were observed during 4639 women-years of follow-up, corresponding to an incidence density of 5 pregnancies for 100 women-years (95% CI: 4.2-5.5). Among the 222 pregnancies recorded, 9(4.0%) ended with abortion, 205(92.4%) with childbirth (including 15 premature childbirths); the outcome of 8(3.6%) pregnancies were unknown abortion. Live birth and stillborn rates were 94.0% (193/205) and 6.0% respectively. The standard fertility rate in our cohort was 45 live births for 1,000 women-years. The general decrease in fertility rates was 66.0% among women infected with HIV compared to the overall population.
  
  
  CONCLUSIONS
  This study shows a low pregnancy incidence among women initiating ART as compared to their peers from the general population. Pregnancies that occurred during ART generally end with live births. Care packages for HIV infected women of childbearing age must include reproductive health services to better address this issue.
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso; Institut Supérieur des Sciences de la Santé (INSSA), Université Polytechnique de Bobo Dioulasso (UPB), Bobo Dioulasso, Burkina Faso.
authors.forename: Armel
authors.initials: A
authors.lastname: Poda
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Arsène
authors.initials: A
authors.lastname: Hema
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Aina
authors.initials: A
authors.lastname: Konaté
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Firmin
authors.initials: F
authors.lastname: Kaboré
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Jacques
authors.initials: J
authors.lastname: Zoungrana
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Euloges
authors.initials: E
authors.lastname: Kamboulé
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Soré
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bado
authors.affiliation: Institut Supérieur des Sciences de la Santé (INSSA), Université Polytechnique de Bobo Dioulasso (UPB), Bobo Dioulasso, Burkina Faso; Service de Bactériologie Virologie, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Abdoul-Salam
authors.initials: AS
authors.lastname: Ouédraogo
authors.affiliation: Institut Supérieur des Sciences de la Santé (INSSA), Université Polytechnique de Bobo Dioulasso (UPB), Bobo Dioulasso, Burkina Faso; Service de Médecine Interne, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Macaire
authors.initials: M
authors.lastname: Ouédraogo
authors.affiliation: Unité de Formation et de Recherche en Sciences de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso; Centre Muraz, Bobo Dioulasso, Burkina Faso.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meda
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso; Unité de Formation et de Recherche en Sciences de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso.
authors.forename: Adrien Bruno
authors.initials: AB
authors.lastname: Sawadogo
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002050:Burkina Faso; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: ART; Burkina Faso; HIV; fertility; pregnancy incidence