The effect of HIV infection on maternal health and mortality.

The effect of HIV infection on maternal mortality is best documented in South Africa, where HIV prevalence rates in pregnancy are among the highest in the world. Since 1998, detailed data on maternal deaths in South Africa have been available in the form of Confidential Enquiries reports. The latest report (Saving Mothers Report, 2005-2007) suggests that the maternal mortality ratio in HIV-infected women was about 10 times higher than in uninfected women. This was in a context where only a small minority of HIV-positive pregnant women were receiving HAART. The most common causes of maternal death among HIV-positive women were nonpregnancy-related infections, including AIDS, pneumonia, tuberculosis, and meningitis. HIV-infected pregnant women were also at greater risk of dying from pregnancy-related sepsis and complications of abortion than their uninfected counterparts. Reduction of HIV-related maternal deaths must be seen as a worldwide priority in maternal health care.