The association between maternal HIV-1 infection and pregnancy outcomes inDar es Salaam, Tanzania

Objective To examine the association between maternal HIV infection and pre gnancy outcomes controlling for potential confounding factors among a cohor t of HIV-uninfected and HIV-infected pregnant women in Dar es Salaam, Tanza nia. Design Prospective cohort study. Methods A cohort of 1078 HIV-infected and 502 HIV-uninfected pregnant women between 12 and 27 weeks of gestation were enrolled and followed up until d elivery. Multiple regression models were used to compare the risk of advers e pregnancy outcomes among HIV-uninfected women with those among HIV-infect ed women overall, and separately among asymptomatic or symptomatic HIV-infe cted women. Results No significant differences between HIV-uninfected women and HIV-inf ected women were observed in risks of fetal loss or low birthweight or in t he weight, head circumference and gestational age of infants at birth. HIV- infected women were more likely to have severe immature infants (< 34 weeks ) than HIV-uninfected women (multivariate RR 1.54 [95% CI 0.90-2.48]; P = 0 .05). There was a significantly higher risk of low birthweight (RR 2.29, 95 % CI 1.34-3.92; P = 0.03) and prematurity (< 37 weeks) (RR 1.93, 95% CI 1.3 5-2.77; P = 0.0003) among symptomatic HIV-infected women when compared with HIV-uninfected women. Conclusion HIV-infected women, particularly those who are symptomatic, are at a higher risk of adverse pregnancy outcomes.