Obstetric and newborn outcomes in a cohort of HIV-infected pregnant women:A report of the women and infants transmission study

Objective: To determine obstetric and neonatal outcomes in a cohort of HIV- infected pregnant women and to assess whether HIV-related immunosuppression increases the risk: of adverse outcomes of pregnancy. Methods: Between 1989 and 1994, interview, physical examination, laboratory , and medical record data were prospectively collected from HIV-infected pr egnant women and on their newborns. Factors associated with adverse pregnan cy outcome and HIV disease status were correlated with pregnancy outcome us ing logistic regression analysis. Results: 634 women delivered after 24 weeks of gestation. Preterm birth, lo w birth weight, and small-for-gestational-age neonates occurred in 20.5%, 1 8.9%, and 24.0% of pregnancies, respectively. Factors associated with low b irth weight were CD4 percentage <14%, history of adverse pregnancy outcome, pediatric HIV infection, bleeding during pregnancy, and Trichomonas infect ion. Preterm birth was associated with CD4 percentage <14%, a history Of ad verse pregnancy outcome, and bleeding during pregnancy. Being small for ges tational age was associated with maternal hard drug use during pregnancy, T richomonas infection, history of adverse pregnancy outcome, and hypertensio n. Conclusions: Adverse pregnancy outcomes are common for HIV-infected women a nd are associated with low maternal CD4 percentage and pediatric HPV infect ion. Preterm birth, low birth weight, and small-for-gestational-age ranking , however, are also associated with previously recognized sociodemographic and obstetric factors that are not unique to HIV infection.