%0 Journal Article %J HIV Med %D 2017 %T Rate, correlates and outcomes of repeat pregnancy in HIV-infected women. %A Floridia, M %A Tamburrini, E %A Masuelli, G %A Martinelli, P %A Spinillo, A %A Liuzzi, G %A Vimercati, A %A Alberico, S %A Maccabruni, A %A Pinnetti, C %A Frisina, V %A Dalzero, S %A Ravizza, M %K Adult %K Anti-HIV Agents %K CD4 Lymphocyte Count %K Emigrants and Immigrants %K Female %K HIV Infections %K HIV-1 %K Humans %K Infant, Low Birth Weight %K Pregnancy %K Premature Birth %K Viral Load %X

OBJECTIVES: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection.

METHODS: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load.

RESULTS: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively).

CONCLUSIONS: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

%B HIV Med %V 18 %P 440-443 %8 2017 07 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/28000379?dopt=Abstract %R 10.1111/hiv.12473