ArticleBMC pediatrics2012
Pregnancy loss and role of infant HIV status on perinatal mortality among HIV-infected women.
Article in BMC pediatrics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Effect of maternal HIV infection on birth outcomes among HIV positive women in Sub Saharan Africa: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Association between maternal HIV infection and low birth weight and prematurity: a meta-analysis of cohort studies.BMC pregnancy and childbirth · 2015Pooled it
- A systematic review of risk factors for neonatal mortality in adolescent mother's in Sub Saharan Africa.BMC research notes · 2014Pooled it
- Adverse Pregnancy Outcomes Among Women Who Conceive on Antiretroviral Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Preimplantation exposure to viral dsRNA impairs decidualization leading to altered placental development and fetal growth restriction.Reproduction & fertility · 2026Article
- The Impact of ART on Stillbirth and Neonatal Death Among HIV-positive Pregnant Women - Yunnan Province, China, 2013-2022.China CDC weekly · 2025Article
- Does Maternal HIV Infection Affect Neonatal Outcomes?Current HIV research · 2024Article
- Endometrial responses to bacterial and viral infection: a scoping review.Human reproduction update · 2023Article
- Pregnancy rates and clinical outcomes among women living with HIV enrolled in HPTN 052.AIDS care · 2023Article
- Understanding clinical outcome measures reported in HIV pregnancy studies involving antiretroviral-naive and antiretroviral-experienced women.The Lancet. Infectious diseases · 2023Review
- Patterns of pregnancy loss among women living with and without HIV in Brazil, 2008-2018.AJOG global reports · 2022Article
- Article
- Association between obstetric and medical risk factors and stillbirths in a low-income urban setting.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021Article
- Miscarriage among women in the United States Women's Interagency HIV Study, 1994-2017.American journal of obstetrics and gynecology · 2019Article
- Maternal and foetal medical conditions during pregnancy as determinants of intrapartum stillbirth in public health facilities of Addis Ababa: a case-control study.The Pan African medical journal · 2019Article
- Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018.Mediterranean journal of hematology and infectious diseases · 2019Article
- Pregnancy Rates and Outcomes of HIV-Infected Women in Korea.Journal of Korean medical science · 2018Article
- Safety and pharmacokinetics of dolutegravir in HIV-positive pregnant women: a systematic review.Journal of virus eradication · 2018Article
- Neonatal and Infant Mortality Risk Associated with Preterm and Small for Gestational Age Births in Tanzania: Individual Level Pooled Analysis Using the Intergrowth Standard.The Journal of pediatrics · 2018Article
- Correlations between intimate partner violence and spontaneous abortion, stillbirth, and neonatal death in rural Malawi.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2017Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundHIV-infected women, particularly those with advanced disease, may have higher rates of pregnancy loss (miscarriage and stillbirth) and neonatal mortality than uninfected women. Here we examine risk factors for these adverse pregnancy outcomes in a cohort of HIV-infected women in Zambia considering the impact of infant HIV status.
methodsA total of 1229 HIV-infected pregnant women were enrolled (2001-2004) in Lusaka, Zambia and followed to pregnancy outcome. Live-born infants were tested for HIV by PCR at birth, 1 week and 5 weeks. Obstetric and neonatal data were collected after delivery and the rates of neonatal (<28 days) and early mortality (<70 days) were described using Kaplan-Meier methods.
resultsThe ratio of miscarriage and stillbirth per 100 live-births were 3.1 and 2.6, respectively. Higher maternal plasma viral load (adjusted odds ratio [AOR] for each log10 increase in HIV RNA copies/ml = 1.90; 95% confidence interval [CI] 1.10-3.27) and being symptomatic were associated with an increased risk of stillbirth (AOR = 3.19; 95% CI 1.46-6.97), and decreasing maternal CD4 count by 100 cells/mm3 with an increased risk of miscarriage (OR = 1.25; 95% CI 1.02-1.54). The neonatal mortality rate was 4.3 per 100 increasing to 6.3 by 70 days. Intrauterine HIV infection was not associated with neonatal morality but became associated with mortality through 70 days (adjusted hazard ratio = 2.76; 95% CI 1.25-6.08). Low birth weight and cessation of breastfeeding were significant risk factors for both neonatal and early mortality independent of infant HIV infection.
conclusionsMore advanced maternal HIV disease was associated with adverse pregnancy outcomes. Excess neonatal mortality in HIV-infected women was not primarily explained by infant HIV infection but was strongly associated with low birth weight and prematurity. Intrauterine HIV infection contributed to mortality as early as 70 days of infant age. Interventions to improve pregnancy outcomes for HIV-infected women are needed to complement necessary therapeutic and prophylactic antiretroviral interventions.
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