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J Infect Dev Ctries ; 14(8): 901-907, 2020 08 31.
Article de Anglais | MEDLINE | ID: mdl-32903235

RÉSUMÉ

INTRODUCTION: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. METHODOLOGY: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well. RESULTS: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV. CONCLUSIONS: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.


Sujet(s)
Développement foetal/effets des médicaments et des substances chimiques , Infections à VIH/traitement médicamenteux , Transmission verticale de maladie infectieuse/prévention et contrôle , Adulte , Agents antiVIH/usage thérapeutique , Thérapie antirétrovirale hautement active/statistiques et données numériques , Études cas-témoins , Femelle , Infections à VIH/épidémiologie , Humains , Nourrisson petit pour son âge gestationnel , Grossesse , Complications infectieuses de la grossesse/traitement médicamenteux , Naissance prématurée/épidémiologie , Études rétrospectives , Facteurs de risque , Taïwan/épidémiologie , Zidovudine/usage thérapeutique
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