Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2016, 2016

Increasing Number and Proportion of Adverse Obstetrical Outcomes among Women Living with HIV in the Ottawa Area: A 20-Year Clinical Case Series (Article) (Open Access)

Buchan S. , Muldoon K.A. , Spaans J.N. , Balfour L. , Samson L. , Walker M. , Cameron D.W.*
  • a Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, Department of Medicine, Division of Infectious Disease, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
  • b Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
  • c Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
  • d Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, Department of Medicine, Division of Infectious Disease, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, Department of Obstetrics and Gynaecology, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
  • e Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada
  • f Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada, Department of Obstetrics and Gynaecology, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
  • g Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, Department of Medicine, Division of Infectious Disease, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada, School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada

Abstract

Background. The prevalence and associated risks with adverse obstetrical outcomes among women living with HIV are not well measured. The objective of this study was to longitudinally investigate the prevalence and correlates of adverse obstetrical outcomes among women with HIV. Methods. This 20-year (1990-2010) clinical case series assessed the prevalence of adverse obstetrical outcomes among pregnant women with HIV receiving care at The Ottawa Hospital (TOH). General estimating equation modeling was used to identify factors independently associated with adverse obstetrical outcomes, while controlling for year of childbirth clustering. Results. At TOH, there were 127 deliveries among 94 women (1990-2010): 22 preterm births, 9 births with low birth weight, 12 births small for gestational age, and 4 stillbirths. Per year, the odds of adverse obstetrical outcomes increased by 15% (OR: 1.15, 95% CI: 1.03-1.30). Psychiatric illness (AOR: 2.64, 95% CI: 1.12-6.24), teen pregnancy (AOR: 3.35, 95% CI: 1.04-1.46), and recent immigrant status (AOR: 7.24, 95% CI: 1.30-40.28) were the strongest correlates of adverse obstetrical outcomes. Conclusions. The increasing number and proportion of adverse obstetrical outcomes among pregnant women with HIV over the past 20 years highlight the need for social supports and maternal and child health interventions, especially among adolescents, new immigrants, and those with a history of mental illness. © 2016 Sarah Buchan et al.

Author Keywords

[No Keywords available]

Index Keywords

immigrant longitudinal study Human immunodeficiency virus infection demography pregnancy complication correlation analysis human premature labor mental disease CD4 lymphocyte count adverse outcome female adolescent pregnancy prevalence Article low birth weight pregnancy outcome major clinical study adult small for date infant health care access virus load case study vaginal delivery pregnant woman stillbirth childbirth nonnucleoside reverse transcriptase inhibitor Human immunodeficiency virus proteinase inhibitor RNA directed DNA polymerase inhibitor cesarean section
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84982078824&doi=10.1155%2f2016%2f1546365&partnerID=40&md5=283647b4ea12f4187ae6b1e21fc91537
DOI: 10.1155/2016/1546365
ISSN: 17129532
Original Language: English