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. 2024 Apr 15;95(5):411-416.
doi: 10.1097/QAI.0000000000003384.

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Winnie Fu  1   2 , Elisabeth McClymont  1   2   3 , Gal Av-Gay  1   2 , Marisa Dorling  1   2 , Andrea Atkinson  1 , Arezou Azampanah  2 , Chelsea Elwood  1   2 , Laura Sauvé  3 , Julie van Schalkwyk  1   2 , Tatiana Sotindjo  3 , Deborah Money  1   2
Affiliations

Retrospective Cohort Study on the Impact of the COVID-19 Pandemic on Pregnancy Outcomes for Women Living With HIV in British Columbia

Winnie Fu et al. J Acquir Immune Defic Syndr. .

Abstract

Background: For pregnant women living with HIV (WLWH), engagement in care is crucial to maternal health and reducing the risk of perinatal transmission. To date, there have been no studies in Canada examining the impact of the COVID-19 pandemic on pregnant WLWH.

Methods: This was a retrospective cohort study assessing the impact of the pandemic on perinatal outcomes for pregnant WLWH using data from the Perinatal HIV Surveillance Program in British Columbia, Canada. We compared maternal characteristics, pregnancy outcomes, and clinical indicators related to engagement with care between a prepandemic (January 2017-March 2020) and pandemic cohort (March 2020-December 2022). We investigated preterm birth rates with explanatory variables using logistic regression analysis.

Results: The prepandemic cohort (n = 87) had a significantly (P < 0.05) lower gestational age at the first antenatal encounter (9.0 vs 11.8) and lower rates of preterm births compared with the pandemic cohort (n = 56; 15% vs 37%). Adjusted odds of preterm birth increased with the presence of substance use in pregnancy (aOR = 10.45, 95% confidence interval: 2.19 to 49.94) in WLWH. There were 2 cases of perinatal transmission of HIV in the pandemic cohort, whereas the prepandemic cohort had none.

Conclusions: The pandemic had pronounced effects on pregnant WLWH and their infants in British Columbia including higher rates of preterm birth and higher gestational age at the first antenatal encounter. The nonstatistically significant increase in perinatal transmission rates is of high clinical importance.

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Conflict of interest statement

E.M. receives salary support in the form of postdoctoral fellowships from the Canadian HIV Trials Network/CANFAR and Michael Smith Health Research BC. A.A. is supported by the RANZCOG Jean Murray-Jones Scholarship. C.E. has served as an advisory board member for Gilead, as a reproductive infectious disease specialist. L.S. has research funding from the Public Health Agency of Canada and Women's Health Research Institute (Vancouver, Canada). T.S. has had contact in consultative capacity with ViiV and Gilead Sciences. For the remaining authors, no conflicts of interest were declared.

References

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