Literature DB >> 22713479

Predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care.

Susie E Huntington1, Claire Thorne, Loveleen K Bansi, Jane Anderson, Marie-Louise Newell, Graham P Taylor, Deenan Pillay, Teresa Hill, Pat A Tookey, Caroline A Sabin.   

Abstract

OBJECTIVES: To describe predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care.
METHODS: Data were obtained through the linkage of two separate studies: the UK Collaborative HIV Cohort study (UK CHIC), a cohort of adults attending 13 large HIV clinics; and the National Study of HIV in Pregnancy and Childhood (NSHPC), a national surveillance study of HIV-positive pregnant women. Pregnancy incidence was measured using the proportion of women in UK CHIC with a pregnancy reported to NSHPC. Generalized estimating equations were used to identify predictors of pregnancy and assess changes in pregnancy incidence in 2000-2009.
RESULTS: The number of women accessing care at UK CHIC sites increased as did the number of pregnancies. Older women were less likely to have a pregnancy [adjusted relative rate (aRR) 0.44 per 10 year increment in age, [95% confidence interval (CI) (0.41-0.46)], P < 0.001] as were women with CD4 cell count less than 200 cells/μl compared with CD4 cell count 200-350 cells/μl [aRR 0.65 (0.55-0.77), P < 0.001] and women of white ethnicity compared with women of black African ethnicity [aRR 0.67 (0.57-0.80), P < 0.001]. The likelihood that women had a pregnancy increased over the study period [aRR 1.05 (1.03-1.07), P < 0.001). The rate of change did not significantly differ according to age group, antiretroviral therapy use, CD4 group or ethnicity.
CONCLUSION: The pregnancy rate among women accessing HIV clinical care increased in 2000-2009. HIV-positive women with, or planning, a pregnancy require a high level of care and this is likely to continue and increase as more women of older age have pregnancies.

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Year:  2013        PMID: 22713479      PMCID: PMC3495056          DOI: 10.1097/QAD.0b013e3283565df1

Source DB:  PubMed          Journal:  AIDS        ISSN: 0269-9370            Impact factor:   4.177


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