Timing is everything: assessing the impact of maternal HIV infection diagnosis timing on infant outcomes in a ten-year retrospective cohort study in South Carolina

AIDS Care. 2021 Mar;33(3):299-305. doi: 10.1080/09540121.2019.1707470. Epub 2019 Dec 23.

Abstract

The aims were to evaluate the impact of maternal HIV infection diagnosis timing on infant outcomes. The outcomes of interest included preterm delivery (PTD) and confirmed infant HIV infection. Data for all HIV-exposed infants from 2004-14 were obtained. Maternal HIV infection diagnosis timing was categorized as: perinatal (PHIV), adult infection before conception, and after conception. Infant outcomes were compared according to timing of maternal HIV diagnosis. Bivariate outcomes were compared using χ2 tests. Continuous variables were compared using Kruskal-Wallis tests. Logistic regression was used to determine predictors of PTD and infant HIV infection. Most women were diagnosed with HIV before conception: PHIV (21, 3%), before conception (431, 69%), and post-conception (176, 28%). Women diagnosed with HIV as an adult before conception were more likely to deliver preterm (P = 0.007). Prenatal care was associated with lower risk of PTD (aOR 0.1, 95% CI 0.04-0.5). Six infants contracted HIV. Infant HIV infection was more likely in women who did not take antiretroviral therapy (aOR 13.5, 95% CI 2.5-72.1) or delivered preterm (aOR 5.3, 95% 1.1-25.1). Women with PHIV were more likely to deliver at term, and there were no HIV infections among PHIV-exposed infants. These findings are reassuring to PHIV women who desire pregnancy.

Keywords: HIV; low birth weight; perinatal; pregnancy; preterm birth; small for gestational age.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • HIV Testing
  • Humans
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Outcome
  • Premature Birth / epidemiology*
  • Premature Birth / virology
  • Retrospective Studies
  • South Carolina / epidemiology
  • Time Factors