title: Rate, correlates and outcomes of repeat pregnancy in HIV-infected women.
abstract: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection.
  
  
  
  Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load.
  
  
  
  The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively).
  
  
  
  Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.
authors.affiliation: Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Floridia
authors.affiliation: Department of Infectious Diseases, Catholic University, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tamburrini
authors.affiliation: Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital and University of Turin, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Masuelli
authors.affiliation: Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Martinelli
authors.affiliation: Department of Obstetrics and Gynaecology, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Spinillo
authors.affiliation: INMI Lazzaro Spallanzani, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Liuzzi
authors.affiliation: Department of Obstetrics and Gynaecology, University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vimercati
authors.affiliation: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Alberico
authors.affiliation: Department of Infectious Diseases, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Maccabruni
authors.affiliation: INMI Lazzaro Spallanzani, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pinnetti
authors.affiliation: Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital and University of Turin, Turin, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Frisina
authors.affiliation: Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Dalzero
authors.affiliation: Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ravizza
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D007230:Infant, Low Birth Weight; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: 
  HIV
  ; 
  HIV RNA
  ; birth weight; pregnancy; preterm delivery