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

106 Scopus citations

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

Keywords

  • AIDS
  • HAART
  • HIV
  • Pregnancy outcome

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Massad, L. S., 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, 18(2), 281-286. https://doi.org/10.1097/00002030-200401230-00018