Hypertension in Pregnancy among HIV-Infected Women in Sub-Saharan Africa: Prevalence and Infant Outcomes

C Kilewo, UCM Natchu, A Young, D Donnell, E Brown, JS Read, U Sharma, BH Chi, R Goldenberg, I Hoffman, TE Taha, WW Fawzi

Abstract

This analysis was performed to determine the prevalence of hypertension and association of MAP (mean arterial pressure) with birth outcomes among HIV-infected pregnant women not taking antiretrovirals. HIV-infected pregnant women, enrolled into the HPTN024 trial in Tanzania, Malawi and Zambia were followed up at 26-30, 36 weeks, and delivery. The prevalence of hypertension was <1% at both 20-24 weeks and 26-30 weeks and 1.7% by 36 weeks. A 5 mm Hg elevation in MAP increased the risk of stillbirth at 20-24 weeks by 29% (p=0.001), 32% (p=0.001) at 26-30 weeks and of low birth weight (LBW) at 36 weeks by 26% (p=0.001). MAP was not associated with stillbirth at 36 weeks, LBW prior to 36 weeks, preterm birth, neonatal mortality or the risk of maternal to child transmission (MTCT) of HIV  (Afr J Reprod Health 2009; 13[4]:25-36).

 

RĖSUMĖ

L’hypertension pendant la grossesse chez les femmes séropositives en Afrique subsaharienne : Prévalence et les résultats infantiles. On a fait cette analyse pour déterminer la prévalence de l’hypertension et l’association de la PAM (Pression Artérielle Moyenne) avec les résultats de naissance chez les femmes séropositives enceintes qui ne prennent pas des médicaments antirétroviraux.  Les femmes séropositives enceintes inscrites pour l’essai PHTNO24 en Tanzanie, au Malawi et en Zambie ont été suivies à 26 – 30, 36 semaines et à l’accouchement.  La prévalence de l’hypertension était <1% à la fin de 20 – 24 semaines et à la fin de 26 – 30 semaines et 1,7% à la fin de 36 semaines.  Une hausse de 5mm Hg de la PAM a augmente le risque de la mortinatalité à la fin de 20 – 24 semaines de 29% (p = 0,001), 32% (p = 0,001) à la fin de 26 – 30 semaines et de la faible poids de naissance (FPN) à la fin de 36 semaines de 26% (p = 0,001).  La PAM n’était pas liée à la mortinatalité à la fin de 36 semaines, à la FPN avant 36 semaines, à la naissance avant-terme, à la mortalité néonatale ou au risque de la transmission de la mère à l’enfant (TME) du VIH  (Afr J Reprod Health 2009; 13[4]:25-36).

 

 

 

KEYWORDS: Perinatal mortality, hypertension, Africa, stillbirth, low birth weight, mean arterial pressure, pregnancy

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