Cohort profile: the Hlabisa pregnancy cohort, KwaZulu-Natal, South Africa.
BMJ Open
; 6(10): e012088, 2016 Oct 17.
Article
en En
| MEDLINE
| ID: mdl-27798004
ABSTRACT
PURPOSE:
The Hlabisa pregnancy cohort was established to evaluate the effectiveness of prevention of mother-to-child transmission (PMTCT) guideline revisions. The objectives of the Hlabisa pregnancy cohort are to (1) provide cohort-level information on maternal health up to 6â weeks postpartum in a high HIV prevalence setting; and to (2) evaluate aspects of PMTCT care that have policy relevance.PARTICIPANTS:
The pregnancy cohort is located in primary health clinics in the Hlabisa subdistrict of rural KwaZulu-Natal, South Africa. Baseline data collection between 2010 and 2014 has been completed with the enrolment of 25â 608 pregnancies; age ranged from 15-49â years. Pregnant women were assessed during routine antenatal visits first visit, follow-up 1â week later, 32â weeks (HIV test), infant delivery and 6â weeks postpartum. Demographic, pregnancy, clinical, laboratory and HIV data were collected through Department of Health interviews, laboratory tests and routine data linkage. Treatment data for HIV-infected pregnant women were linked to the Africa Centre Hlabisa HIV Treatment and Care Programme for detailed antiretroviral therapy (ART) history and laboratory tests. FINDINGS TO DATE The proportion of women initiated on ART post-2013 were higher (n=437; 100%) than pre-2013 (n=768; 84.2%). The proportion of women in care at 6â weeks (73.8%) was also higher post-2013 relative to earlier years (58.5%). The majority of HIV-infected pregnant women were either on lifelong ART or ART prophylaxis; pre-2013, â¼ 9.6% of women were not on any ART. Pregnancy viral load monitoring was inadequate. FUTURE PLANS This cohort will be used to (1) determine HIV acquisition risk during pregnancy and postpartum; (2) determine the effect of HIV and ART on birth outcomes; (3) examine the effect of pregnancy on virological response to ART; and (4) characterise the effect of sequential pregnancies on access to clinical care, response to prolonged ART and birth outcomes.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Complicaciones Infecciosas del Embarazo
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Infecciones por VIH
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Transmisión Vertical de Enfermedad Infecciosa
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Fármacos Anti-VIH
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Adhesión a Directriz
Tipo de estudio:
Etiology_studies
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Guideline
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Incidence_studies
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Observational_studies
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Qualitative_research
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
BMJ Open
Año:
2016
Tipo del documento:
Article
País de afiliación:
Sudáfrica