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. 2021 Sep 15;73(6):969-978.
doi: 10.1093/cid/ciab203.

Profile of Chronic Comorbid Conditions and Obstetrical Complications Among Pregnant Women With Human Immunodeficiency Virus and Receiving Antiretroviral Therapy in the United States

Kartik K Venkatesh  1 , Leavitt Morrison  2 , Ruth E Tuomala  3 , Alice Stek  4 , Jennifer S Read  5 , David E Shapiro  2 , Elizabeth G Livingston  6
Affiliations

Profile of Chronic Comorbid Conditions and Obstetrical Complications Among Pregnant Women With Human Immunodeficiency Virus and Receiving Antiretroviral Therapy in the United States

Kartik K Venkatesh et al. Clin Infect Dis. .

Abstract

Background: To evaluate the frequency and associated characteristics of chronic comorbid conditions and obstetrical complications among pregnant women with human immunodeficiency virus (HIV) and receiving antiretroviral therapy (ART) in comparison to those without HIV.

Methods: We compared 2 independent concurrent US pregnancy cohorts: (1) with HIV (International Maternal Pediatric Adolescent AIDS Clinical Trials Protocol P1025, 2002-2013) and (2) without HIV (Consortium for Safe Labor Study, 2002-2007). Outcomes were ≥2 chronic comorbid conditions and obstetrical complications. For women with HIV, we assessed whether late prenatal care (≥14 weeks), starting ART in an earlier era (2002-2008), and a detectable viral load at delivery (≥400 copies/mL) were associated with study outcomes.

Results: We assessed 2868 deliveries (n = 2574 women) with HIV and receiving ART and 211 910 deliveries (n = 193 170 women) without HIV. Women with HIV were more likely to have ≥2 chronic comorbid conditions versus those without HIV (10 vs 3%; adjusted OR [AOR]: 2.96; 95% CI: 2.58-3.41). Women with HIV were slightly less likely to have obstetrical complications versus those without HIV (both 17%; AOR: .84; 95% CI: .75-.94), but secondarily, higher odds of preterm birth <37 weeks. Late entry to prenatal care and starting ART in an earlier era were associated with a lower likelihood of ≥2 chronic comorbidities and obstetrical complications; detectable viral load at delivery was associated with a higher likelihood of obstetric complications.

Conclusions: Pregnant women with HIV receiving ART have more chronic comorbid conditions, but not necessarily obstetrical complications, than their peers without HIV.

Keywords: HIV; comorbid conditions; comorbidities; morbidity; pregnancy.

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Figures

Figure 1.
Figure 1.
A, Bubble plot of relationship between chronic comorbid conditions for deliveries to women with (IMPAACT P1025) and without (CSL) HIV. B, Bubble plot of relationship between obstetrical conditions among women with (IMPAACT P1025) and without (CSL) HIV. All values are percentages. Values ≥1.0 have been rounded to the nearest whole number, while values <1.0 have been rounded to the nearest tenth (0.1). Abbreviations: CSL, Consortium on Safe Labor; HIV, human immunodeficiency virus; IMPAACT P1025, International Maternal Pediatric Adolescent AIDS Clinical Trials Protocol P1025.
Figure 2.
Figure 2.
Frequency (%) of chronic comorbid conditions and obstetric complications among deliveries to women with and without HIV infection. A, Chronic comorbid conditions (%). B, Obstetrical/infant complications (%). The results are presented as frequencies (n and %) in Supplementary Table 2. Abbreviations: CSL, Consortium on Safe Labor; HIV, human immunodeficiency virus; IMPAACT P1025, International Maternal Pediatric Adolescent AIDS Clinical Trials Protocol P1025.
See this image and copyright information in PMC

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