Feto-Maternal Outcome of HIV Positive Pregnant Women on HAART at the Gambia - Case - Control Study

Abstract

Introduction HIV infection in pregnant women remains a huge public health concern globally. There are conflicting reports regarding the effects of HIV infection on pregnancy outcomes in the highly active antiretroviral therapy (HAART) for all patient era. The objective was to compare pregnancy outcomes among HIVinfected and uninfected women in Edward Francis Small Teaching Hospital, Banjul, Gambia. Methods Pregnant women attending antenatal clinic at the hospital were prospectively recruited and followed-up. HIVpositive and -negative mothers were matched for age and parity. Recruitment occurred irrespective of gestational age. At the time of delivery, obstetric and neonatal characteristics were entered into the computer database. Mothers and their children were followed until 6 weeks postpartum. The data were analysed with EPI-INFO version 7.1.5. Chi-square test at significant level of 0.05 and confidence level of 95% were used to determine significance. Results A total of 166 mothers, 55 HIV-positive and 111 HIVnegative controls, were in the study. The age range was between 18 and 45 years and parity was 0 to 8. The measured adverse outcome includes; low birthweight (20% versus 5.2%, odds ratio [OR] 4.6, 95% confidence interval [95% CI] 1.46-14.2; P = 0.01220) and maternal anaemia (40% versus 11%, OR 5.4, 95% CI 2.3-12.6; P = 0.0001). Both showed statistical significant difference. Preterm delivery; 29.2% and 26.6% (OR 1.14, 95% CI 0.52-2.46; P = 0.9) and stillbirth, low Apgar score at 5 minutes and SBCU admission of 5.45% versus 0-0.9% showed no statistical difference (OR 6.3, 95% CI 0.6-6.25; P = 0.21). The absolute CD4 count of 350 cells/mm3 and above (57.13%) was associated with low incidence of low birthweight. The mean glycaemic results were within normal range, 4.02-4.75 and 5.00- 6.79 mmol/L pre- and post-prandial, respectively. Conclusion HIV infection could be an independent risk factor for low birthweight and maternal anaemia.