IMPACT OF PREGNANCY ON MATERNAL AIDS

OBJECTIVE: To assess the impact of pregnancy on maternal acquired immu nodeficiency syndrome (AIDS) among tribal women in India. STUDY DESIGN : From February 1942 to February 1996, 71 tribal women from Manipur, I ndia, with AIDS (Centers for Disease Control stage iii/iv), matched fo r age, parity, CD, lymphocyte count and demographic characteristics, w ere recruited into a prospective study. Thirty-two (49%) of these wome n were pregnant (8-20 weeks) (group A) and 38 (51%) nonpregnant (group B). RESULTS: Pneumocystis carinii pneumonia followed by miliary tuber culosis and wasting disease were the most common AIDS-defining illness and cause of maternal death in both groups. A total of 28 (39%) women died as a direct result of their AIDS-defining illness; 10 (27%) of t hem were among the nonpregnant women as compared to 18 (56%) deaths am ong the pregnant women (P = .17, odds ratio 3.7285, 95% confidence int erval 1.23, 11.58). Three (16%) of these 18 deaths occurred within 14 weeks of an uneventful first-trimester medical termination of pregnanc y. Thirteen women (41%) died undelivered at 30-34 weeks' gestation, an d two died within 3 weeks of delivery. Fourteen (44%) women vaginally delivered 24 preterm infants, between 28 and 35 weeks' gestation. Elev en of these infants died within six weeks; nine deaths were a direct r esult of prematurity and clinical diagnosis of an AIDS-defining illnes s. The mean survival time was 9.72 months far the pregnant women and 2 2.6 months for the nonpregnant women (P = .066). CONCLUSION: Pregnancy increased maternal and fetal mortality in these AIDS-infected women.