Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV

L. Stewart Massad, Gayle Springer, Lisa Jacobson, Heather Watts, Kathryn Anastos, Abner Korn, Helen Cejtin, Alice Stek, Mary Young, Julie Schmidt, Howard Minkoff

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Objective: To determine frequency and outcomes of pregnancy in US women with HIV before and after introduction of highly active antiretroviral therapy (HAART). Design: Prospective cohort study at six US centers. Methods: HIV seropositive and at-risk seronegative women reported pregnancy outcomes at 6-month intervals during the period 1 October 1994 to 31 March 2002. Outcomes were tabulated and pregnancy rates calculated. Logistic regression defined outcome correlates. Results: Pregnancy rates were 7.4 and 15.2 per 100 person-years in seropositive and seronegative women, respectively (P < 0.0001). Among seropositives, 119 (36%) pregnancies ended in live birth, six (2%) in stillbirth, 126 (36%) in abortion, 83 (24%) in miscarriage, 16 (5%) in ectopic pregnancy, and two (1%) in other outcomes (P = nonsignificant versus seronegatives). Independent baseline correlates of conception in seropositives included younger age [odds ratio (OR), 1.20; 95% confidence interval (CI), 1.16-1.23], prior abortion (OR, 1.79; 95% CI, 1.25-2.63), lower HIV RNA levels (OR, 1.30; 95% CI, 1.10-1.54 for each log decrease), and being unmarried (OR, 1.59; 95% CI, 1.02-2.44). Baseline antiretroviral use at baseline was linked to lower conception risk (OR, 0.34; 95% CI, 0.49-0.98 for mono- or combination therapy; OR, 0.34; 95% CI, 0.03-4.28 for HAART). Abortion was less likely during the HAART era, (OR, 0.68; 95% CI, 0.35-1.33 during the early HAART era; OR, 0.46; 95% CI, 0.23-0.90 during the later HAART era, compared with before HAART). Conclusions: Women with HIV were less likely to conceive than at-risk uninfected women, but pregnancy outcomes were similar. Abortion became less common after the introduction of HAART.

Original languageEnglish (US)
Pages (from-to)281-286
Number of pages6
JournalAIDS
Volume18
Issue number2
DOIs
StatePublished - Jan 23 2004

Fingerprint

Spontaneous Abortion
Pregnancy Rate
Highly Active Antiretroviral Therapy
Odds Ratio
HIV
Confidence Intervals
Pregnancy Outcome
Stillbirth
Ectopic Pregnancy
Live Birth
Secondary Prevention
Cohort Studies
Logistic Models
Prospective Studies
RNA
Pregnancy

Keywords

  • AIDS
  • HAART
  • HIV
  • Pregnancy outcome

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Massad, L. S., Springer, G., Jacobson, L., Watts, H., Anastos, K., Korn, A., ... Minkoff, H. (2004). Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV. AIDS, 18(2), 281-286. https://doi.org/10.1097/00002030-200401230-00018

Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV. / Massad, L. Stewart; Springer, Gayle; Jacobson, Lisa; Watts, Heather; Anastos, Kathryn; Korn, Abner; Cejtin, Helen; Stek, Alice; Young, Mary; Schmidt, Julie; Minkoff, Howard.

In: AIDS, Vol. 18, No. 2, 23.01.2004, p. 281-286.

Research output: Contribution to journalArticle

Massad, LS, Springer, G, Jacobson, L, Watts, H, Anastos, K, Korn, A, Cejtin, H, Stek, A, Young, M, Schmidt, J & Minkoff, H 2004, 'Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV', AIDS, vol. 18, no. 2, pp. 281-286. https://doi.org/10.1097/00002030-200401230-00018
Massad, L. Stewart ; Springer, Gayle ; Jacobson, Lisa ; Watts, Heather ; Anastos, Kathryn ; Korn, Abner ; Cejtin, Helen ; Stek, Alice ; Young, Mary ; Schmidt, Julie ; Minkoff, Howard. / Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV. In: AIDS. 2004 ; Vol. 18, No. 2. pp. 281-286.
@article{85f32285612a4359a7726d4c10541180,
title = "Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV",
abstract = "Objective: To determine frequency and outcomes of pregnancy in US women with HIV before and after introduction of highly active antiretroviral therapy (HAART). Design: Prospective cohort study at six US centers. Methods: HIV seropositive and at-risk seronegative women reported pregnancy outcomes at 6-month intervals during the period 1 October 1994 to 31 March 2002. Outcomes were tabulated and pregnancy rates calculated. Logistic regression defined outcome correlates. Results: Pregnancy rates were 7.4 and 15.2 per 100 person-years in seropositive and seronegative women, respectively (P < 0.0001). Among seropositives, 119 (36{\%}) pregnancies ended in live birth, six (2{\%}) in stillbirth, 126 (36{\%}) in abortion, 83 (24{\%}) in miscarriage, 16 (5{\%}) in ectopic pregnancy, and two (1{\%}) in other outcomes (P = nonsignificant versus seronegatives). Independent baseline correlates of conception in seropositives included younger age [odds ratio (OR), 1.20; 95{\%} confidence interval (CI), 1.16-1.23], prior abortion (OR, 1.79; 95{\%} CI, 1.25-2.63), lower HIV RNA levels (OR, 1.30; 95{\%} CI, 1.10-1.54 for each log decrease), and being unmarried (OR, 1.59; 95{\%} CI, 1.02-2.44). Baseline antiretroviral use at baseline was linked to lower conception risk (OR, 0.34; 95{\%} CI, 0.49-0.98 for mono- or combination therapy; OR, 0.34; 95{\%} CI, 0.03-4.28 for HAART). Abortion was less likely during the HAART era, (OR, 0.68; 95{\%} CI, 0.35-1.33 during the early HAART era; OR, 0.46; 95{\%} CI, 0.23-0.90 during the later HAART era, compared with before HAART). Conclusions: Women with HIV were less likely to conceive than at-risk uninfected women, but pregnancy outcomes were similar. Abortion became less common after the introduction of HAART.",
keywords = "AIDS, HAART, HIV, Pregnancy outcome",
author = "Massad, {L. Stewart} and Gayle Springer and Lisa Jacobson and Heather Watts and Kathryn Anastos and Abner Korn and Helen Cejtin and Alice Stek and Mary Young and Julie Schmidt and Howard Minkoff",
year = "2004",
month = "1",
day = "23",
doi = "10.1097/00002030-200401230-00018",
language = "English (US)",
volume = "18",
pages = "281--286",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV

AU - Massad, L. Stewart

AU - Springer, Gayle

AU - Jacobson, Lisa

AU - Watts, Heather

AU - Anastos, Kathryn

AU - Korn, Abner

AU - Cejtin, Helen

AU - Stek, Alice

AU - Young, Mary

AU - Schmidt, Julie

AU - Minkoff, Howard

PY - 2004/1/23

Y1 - 2004/1/23

N2 - Objective: To determine frequency and outcomes of pregnancy in US women with HIV before and after introduction of highly active antiretroviral therapy (HAART). Design: Prospective cohort study at six US centers. Methods: HIV seropositive and at-risk seronegative women reported pregnancy outcomes at 6-month intervals during the period 1 October 1994 to 31 March 2002. Outcomes were tabulated and pregnancy rates calculated. Logistic regression defined outcome correlates. Results: Pregnancy rates were 7.4 and 15.2 per 100 person-years in seropositive and seronegative women, respectively (P < 0.0001). Among seropositives, 119 (36%) pregnancies ended in live birth, six (2%) in stillbirth, 126 (36%) in abortion, 83 (24%) in miscarriage, 16 (5%) in ectopic pregnancy, and two (1%) in other outcomes (P = nonsignificant versus seronegatives). Independent baseline correlates of conception in seropositives included younger age [odds ratio (OR), 1.20; 95% confidence interval (CI), 1.16-1.23], prior abortion (OR, 1.79; 95% CI, 1.25-2.63), lower HIV RNA levels (OR, 1.30; 95% CI, 1.10-1.54 for each log decrease), and being unmarried (OR, 1.59; 95% CI, 1.02-2.44). Baseline antiretroviral use at baseline was linked to lower conception risk (OR, 0.34; 95% CI, 0.49-0.98 for mono- or combination therapy; OR, 0.34; 95% CI, 0.03-4.28 for HAART). Abortion was less likely during the HAART era, (OR, 0.68; 95% CI, 0.35-1.33 during the early HAART era; OR, 0.46; 95% CI, 0.23-0.90 during the later HAART era, compared with before HAART). Conclusions: Women with HIV were less likely to conceive than at-risk uninfected women, but pregnancy outcomes were similar. Abortion became less common after the introduction of HAART.

AB - Objective: To determine frequency and outcomes of pregnancy in US women with HIV before and after introduction of highly active antiretroviral therapy (HAART). Design: Prospective cohort study at six US centers. Methods: HIV seropositive and at-risk seronegative women reported pregnancy outcomes at 6-month intervals during the period 1 October 1994 to 31 March 2002. Outcomes were tabulated and pregnancy rates calculated. Logistic regression defined outcome correlates. Results: Pregnancy rates were 7.4 and 15.2 per 100 person-years in seropositive and seronegative women, respectively (P < 0.0001). Among seropositives, 119 (36%) pregnancies ended in live birth, six (2%) in stillbirth, 126 (36%) in abortion, 83 (24%) in miscarriage, 16 (5%) in ectopic pregnancy, and two (1%) in other outcomes (P = nonsignificant versus seronegatives). Independent baseline correlates of conception in seropositives included younger age [odds ratio (OR), 1.20; 95% confidence interval (CI), 1.16-1.23], prior abortion (OR, 1.79; 95% CI, 1.25-2.63), lower HIV RNA levels (OR, 1.30; 95% CI, 1.10-1.54 for each log decrease), and being unmarried (OR, 1.59; 95% CI, 1.02-2.44). Baseline antiretroviral use at baseline was linked to lower conception risk (OR, 0.34; 95% CI, 0.49-0.98 for mono- or combination therapy; OR, 0.34; 95% CI, 0.03-4.28 for HAART). Abortion was less likely during the HAART era, (OR, 0.68; 95% CI, 0.35-1.33 during the early HAART era; OR, 0.46; 95% CI, 0.23-0.90 during the later HAART era, compared with before HAART). Conclusions: Women with HIV were less likely to conceive than at-risk uninfected women, but pregnancy outcomes were similar. Abortion became less common after the introduction of HAART.

KW - AIDS

KW - HAART

KW - HIV

KW - Pregnancy outcome

UR - http://www.scopus.com/inward/record.url?scp=10744232397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744232397&partnerID=8YFLogxK

U2 - 10.1097/00002030-200401230-00018

DO - 10.1097/00002030-200401230-00018

M3 - Article

VL - 18

SP - 281

EP - 286

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 2

ER -