Adverse Perinatal Outcomes in Pregnant Women with HIV on Antiretroviral Therapy
Author Information
Author(s): Hey Molly, Thompson Lucy, Portwood Clara, Sexton Harriet, Kumarendran Mary, Brandon Zoe, Kirtley Shona, Hemelaar Joris
Primary Institution: National Perinatal Epidemiology Unit, University of Oxford
Hypothesis
The risk of adverse perinatal outcomes may differ according to the class of antiretroviral therapy (ART) regimen in pregnant women with HIV compared to women without HIV.
Conclusion
The risks of adverse perinatal outcomes are higher among women with HIV receiving ART compared to women without HIV, irrespective of the class of ART drugs.
Supporting Evidence
- Women with HIV receiving NNRTI-based ART are at an increased risk of preterm birth.
- Women with HIV receiving protease inhibitor based ART have a higher risk of low birth weight.
- Women with HIV receiving INSTI-based ART are at an increased risk of small for gestational age infants.
Takeaway
Pregnant women with HIV are more likely to have problems like premature births and low birth weight, even when they take medicine to help them.
Methodology
A systematic review and meta-analysis of cohort studies assessing adverse perinatal outcomes among women with HIV receiving different classes of ART.
Potential Biases
Potential indication bias due to differences in health status between women with and without HIV.
Limitations
All included studies were observational, which limits the ability to establish causality and may introduce bias; also, there was high heterogeneity among studies.
Participant Demographics
The study included 191,857 women across 22 cohort studies from 10 countries, with a majority from low and middle-income countries.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 1.27–1.56
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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