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Pregnancy Outcomes in the Era of Universal Antiretroviral Treatment in Sub-Saharan Africa (POISE Study).


ABSTRACT: BACKGROUND:Adverse pregnancy outcomes such as preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) remain major global problems. We compared pregnancy outcomes among HIV-infected women receiving antiretroviral treatment (ART) and with CD4 ?350 cells, and HIV-uninfected women to assess whether disparities associated with HIV infection have been eliminated through use of ART. SETTING:Observational study conducted at 5 health facilities in Blantyre, Malawi, during 2016-2017. METHODS:HIV-infected women receiving the national ART regimen (efavirenz + lamivudine + tenofovir) and HIV-uninfected women were consented and enrolled at delivery. Data collected included sociodemographic and clinical; gestational age; BW; infant/maternal anthropometry; and laboratory results. We defined PTB as GA <37 weeks; LBW as BW <2·5 kg; and SGA as BW <10th percentile of GA. SGA infants were classified into proportionate and disproportionate based on ponderal index. Descriptive, stratified, and multivariate logistic and linear regression analyses were used. RESULTS:Of 5423 women approached, 614 HIV-infected and 685 HIV-uninfected women were enrolled. Rates of PTB, LBW, and SGA were 10.6%, 7.2%, and 17.1% among HIV-infected women on ART and 9.5%, 5.0%, and 18.4% among HIV-uninfected women, respectively. None of these differences were statistically significant in univariate- or multivariate-adjusted analyses (P > 0.05). Of 231 SGA infants, 78.8% were proportionate and 21% were disproportionate. Of the 614 HIV-infected women on ART, 75% had undetectable virus at delivery. CONCLUSIONS:ART use has reduced the high rates of adverse pregnancy outcomes among HIV-infected women. However, the rates remain high irrespective of HIV infection and require appropriate interventions.

SUBMITTER: Dadabhai S 

PROVIDER: S-EPMC6289692 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Pregnancy Outcomes in the Era of Universal Antiretroviral Treatment in Sub-Saharan Africa (POISE Study).

Dadabhai Sufia S   Gadama Luis L   Chamanga Rachel R   Kawalazira Rachel R   Katumbi Chaplain C   Makanani Bonus B   Dula Dingase D   Hua Nan N   Lau Bryan B   Mallewa Macpherson M   Taha Taha E TE  

Journal of acquired immune deficiency syndromes (1999) 20190101 1


<h4>Background</h4>Adverse pregnancy outcomes such as preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) remain major global problems. We compared pregnancy outcomes among HIV-infected women receiving antiretroviral treatment (ART) and with CD4 ≥350 cells, and HIV-uninfected women to assess whether disparities associated with HIV infection have been eliminated through use of ART.<h4>Setting</h4>Observational study conducted at 5 health facilities in Blantyre, Malawi  ...[more]

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