Absence of Antenatal Care and Antiretroviral Therapy Associated with Preterm Delivery in Women with HIV: An 11-Year Retrospective Cohort in South Carolina.

PURPOSE: Our primary aim was to determine if combined antiretroviral therapy (cART) increased the risk of poor infant outcomes among women with HIV. METHODS: Maternal antiretroviral regimens were classified as mono-(mARV), dual (dARV), cART, and no ARV. Differences in dichotomous outcomes were compared using χ2 tests and continuous outcomes were compared using Kruskal-Wallis tests. Predictors of preterm delivery (PTD), low birth weight, and perinatal HIV infection were determined using logistic regression. RESULTS: During the 11-year study period, 643 mother-baby pairs with HIV exposure were eligible for analysis. Non-Hispanic, Black women were more likely to report mARV or no ARV use (p=.03). Women not taking ARVs were more likely to have PTD (p=.01). Prenatal care was associated with a reduction in PTD [aOR 0.12 (95% CI 0.03-0.5)] and perinatal HIV infection [aOR 0.1 (95% CI 0.01-0.7)]. CONCLUSIONS: Maternal cART and race were not associated with PTD. Rather, absence of prenatal care and lack of ARV use during pregnancy increased the risk of PTD and perinatal HIV infection.