Evidence map›Paper›PMID 34704251›Full record

SynthesisActa obstetricia et gynecologica Scandinavica2022

Perinatal outcomes in women living with HIV-1 and receiving antiretroviral therapy-a systematic review and meta-analysis.

Shiri Shinar, Swati Agrawal, Michelle Ryu, Sharon Walmsley, Lena Serghides, Mark H Yudin, Kellie E Murphy

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06971445 (Effect of Polyunsaturated Fatty Acids Omega-3 Supplementation on Pregnancy Outcomes and Inflammation Markers in Pregnant Women HIV+, With Antiretroviral Therapy, Randomized Clinical Trial.), which is not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 3 pooled it
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06971445 naenrolling by invitationnot on this mapstarted 2025, after this paper: background citation

Effect of Polyunsaturated Fatty Acids Omega-3 Supplementation on Pregnancy Outcomes and Inflammation Markers in Pregnant Women HIV+, With Antiretroviral Therapy, Randomized Clinical Trial.

TypeinterventionalSponsorInstituto Nacional de Perinatologia Isidro Espinosa de los ReyesRan2025 to 2029Enrolled92ConditionsPregnant HIV Positive WomenArmsomega-3 polyunsaturated fatty acids (PUFA n-3), Olive oil (placebo)
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.

  1. Pooled it
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  12. Observational
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  17. Review
  18. Bictegravir Use During Pregnancy: A Multicenter Retrospective Analysis Evaluating HIV Viral Suppression and Perinatal Outcomes.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Shiri ShinarDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-6352-4846
Swati AgrawalDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Michelle RyuSidney Liswood Health Sciences Library, Sinai Health System, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-0499-6856
Sharon WalmsleyImmunodeficiency Clinic, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Ontario, Canada.
Lena SerghidesToronto General Hospital Research Institute, University Health Network, Ontario, Canada.
Mark H YudinDepartment of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-7540-8487
Kellie E MurphyDepartment of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Mount Sinai Hospital · CAUniversity Health Network · CASt. Michael's Hospital · CATrillium Health Centre · CA

Funding

Canadian Foundation for AIDS Research 26-021
6 · The paper itself

Abstract

introductionAntiretroviral therapy-naïve pregnant women living with HIV are at an increased risk for adverse pregnancy outcomes. It remains controversial whether this risk persists with antiretroviral therapy. We conducted a systematic review and meta-analysis to evaluate whether pregnant women living with HIV and receiving antiretroviral therapy antenatally, are at an increased risk of adverse outcomes compared with HIV-negative controls. MATERIAL AND

methodsWe searched MEDLINE, Embase, International Pharmaceutical Abstracts, EBM Reviews, PubMed (non-MEDLINE records), EBSCO CINAHL Complete, Clarivate Web of Science, African Index Medicus, LILACS and Google Scholar for all observational studies comparing pregnant women living with HIV on antiretroviral therapy with HIV-negative controls from 1 January 1994 to 10 August 2021 with no language or geographic restrictions. Perinatal outcomes included preterm birth (PTB), low birthweight, small-for-gestational age and preeclampsia. Using a random-effects model we pooled raw data to generate odds ratio (OR) with 95% confidence intervals (CI) for each outcome. Sub-analyses for high and low resource countries and time of antiretroviral therapy initiation were performed. This systematic review and meta-analysis is registered with PROSPERO, number CRD42020182722.

resultsOf the 7900 citations identified, 27 were eligible for analysis (12 636 pregnant women living with HIV on antiretroviral therapy and 7 812 115 HIV-negative controls). ORs (95% CI) of PTB (1.88 [1.63-2.17]), small-for-gestational age (1.60 [1.18-2.17]) and low birthweight (2.15 [1.58-2.92]) were significantly higher in pregnant women living with HIV than in HIV-negative women, while the risk of preeclampsia (0.86 [0.57-1.30]) was comparable. The risk of PTB and low birthweight was higher in both high resource and low resource countries, while the risk of small-for-gestational age was higher only in the former. Preconceptional antiretroviral therapy was associated with a higher risk of PTB compared with antenatal initiation.

conclusionsPregnant women living with HIV on antiretroviral therapy have an increased risk of PTB, low birthweight and small-for-gestational age in high resource countries, as well as PTB and low birthweight in low income countries compared with HIV-negative controls.

Indexed as

Antiretroviral Therapy, Highly ActiveHIV-1Prenatal CareFemaleHIV InfectionsHumansPregnancyPregnancy Complications, InfectiousPregnancy OutcomePremature BirthRisk FactorsHIV/AIDSlow birthweightpreeclampsiapreterm birthsmall-for-gestational age

Identifiers

PMID34704251
PMCPMC9564575
OpenAlexW3208377797

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.