Morris AB, Dobles AR, Zorrilla C, Anderson JR, Cu-Uvin S, Keller J, Harwell JI, Garb JL; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. WePeB5917.
Community Research Initiative of New England, Springfield, MA, United States
OBJECTIVES: To better understand the effects of PIs in pregnancy on prematurity, maternal & infant adverse events, and infant outcomes. METHODS: Medical records of pregnant women treated with PIs at 5 sites were reviewed. Demographics, maternal CD4 and viral load (VL) data, prematurity, infant infection status, and maternal and infant adverse events were recorded. RESULTS 233 pregnancies reported. 87% acquired HIV heterosexually. 73% asymptomatic HIV infection. Mean age:28 yr. 47% Latina;31% African-American;15% Caucasian. Mean CD4 cells at beginning of pregnancy 403+/-242mm3; mean VL 59,883 copies/ml [range,<50-3,611,554]. 53% ART naive; 70% PI naive. 215 on nelfinavir, 13 saquinavir, 16 indinavir, 10 ritonavir. 12 >1 PI. 19% on PIs at conception. 18% began PIs in 1st trimester; 42% 2nd; 22% 3rd. 56% had VL <400 copies/ml at latest test in pregnancy. 55% delivered by elective cesarean section (CS); 10% by unscheduled CS. 22.5% [95%CI,17-28%] pregnancies were <37 weeks gestation including 3 twin and 1 triplet pregnancy. 25% [95%CI,19-31%] of infants had birth weights (BW) <2500 grams including 4 sets of twins and 1 set of triplets. Mean BW:2817+/-626 grams. Obstetric complications include 2 placenta previa, 2 abruption, 3 gestational diabetes, 4 oligohydramnios, 5 chorioamnionitis, 8 preeclampsia, 2 spontaneous abortions, 3 fetal demise and 1stillbirth. Perinatal transmission is documented in 2 of 221 infants for a rate of 0.9%, [95%CI, 0-2.2%]. 1 HIV+ infant delivered by elective CS at 37.14 wks to mother with VL of 5403; the other delivered by unscheduled CS at 32.86 wks to a mother with undetectable VL but multiple STDs during pregnancy. CONCLUSIONS: In this series perinatal transmission is low. The prematurity rate is similar to prior data in HIV+ women not on PIs. Adverse events in mothers on PIs are similar to our prior report in the same population and to that of the general population.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Birth Weight
- CD4-Positive T-Lymphocytes
- Cesarean Section
- Female
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Infant
- Pregnancy
- Pregnancy Complications
- Pregnancy Outcome
- Pregnancy, Multiple
- Protease Inhibitors
- Triplets
- Twins
- Viral Load
- surgery
- utilization
Other ID:
UI: 102251896
From Meeting Abstracts