Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive Nigerian Women

Ezechi O. C., Gab-Okafor C. V., Oladele DA, Kalejaiye O.O, Oke B., Ohwodo H. O., Adu R. A., Ekama S. O., Musa Z., Onwujekwe D. I., David A. N., Ujah I. AO

Abstract

While the effect of HIV infection on some maternal outcomes is well established, for some others there is conflicting information on possible association with HIV. In this study we investigated pregnancy and neonatal outcome of HIV positive women in large HIV treatment centre over a period of 84 months. They were managed according to the Nigerian PMTCT protocol. Adverse obstetric and neonatal outcome were observed in 48.3% HIV positives compared 30.3% to the negatives (OR: 2.08; CI: 1.842.34). Low birth weight ( OR:2.95; CI:1.95-3.1), preterm delivery (OR:2.05;CI:1.3-3.1), perinatal death (OR:1.9;CI:1.3-3.2), and spontaneous abortion (OR:1.37; CI:1.1-2.3)  were  factors found to be  independently associated with HIV. Low CD4 count (OR: 2.45; CI: 1.34- 4.56) and opportunistic infections (OR: 2.11; CI: 1.56-3.45) were to be associated with adverse obstetric and neonatal outcome. This study confirms the association of HIV, severe immunosuppression and opportunistic infection and adverse obstetric and neonatal outcome. (Afr J Reprod Health 2013; 17[3]: 160-168).

 

Résumé

 

Alors  que l'effet de l'infection par le VIH sur certains résultats maternels sont bien établis,  pour certains d'autres, il ya des informations contradictoires sur l'association possible avec le VIH.  Dans cette étude, nous avons étudié la grossesse et l'état néonatal des femmes séropositives dans un grand centre de traitement du VIH au cours d’une période de 84 mois. Elles étaient prises en charge  selon le protocole nigérian de PTME. On a remarqué des résultats obstétricaux et néonatals Indésirables  chez 48,3% des séropositives par rapport à 30,3% pour les négatifs (OR: 2,08, IC: 1,84 à 2,34). Le faible poids de naissance (OR: 2,95, IC : 1,95-3 ,1), l'accouchement prématuré (OR: 2,05, IC : 1,3-3 ,1), la mortalité périnatale (OR: 1,9, IC : 1,3-3 ,2), et l'avortement spontané (OR: 1,37 IC :1,1-2 3) étaient des facteurs qui seraient associés de façon indépendante avec le VIH. Les femmes qui ont  un faible taux de CD4 (OR: 2,45, IC: 1,34 à 4,56) et les infections opportunistes (OR: 2,11, IC : 1,56-3 .45) devaient être associées aux résultats obstétricaux  et néonatals défavorables. Cette étude confirme l'association entre le VIH,  l’immunosuppression sévère et l’infection opportuniste,  les résultats obstétricaux et néonatals défavorables. (Afr J Reprod Health 2013; 17[3]: 160-168).

 

Keywords: Pregnancy, delivery, HIV, neonate, adverse outcome

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