Maternal and perinatal morbidity and mortality in patients with HIV infection at Hospital Simón Bolívar, 2003-2011, Bogotá (Colombia)
DOI:
https://doi.org/10.18597/rcog.34Keywords:
HIV, pregnancy, pregnancy complications, labour complications, perinatal mortality, maternal mortalityAbstract
Objective: To describe maternal and perinatal HIV-associated morbidity and mortality at Simón Bolívar Hospital between 2003 and 2011.
Materials and methods: A descriptive historical cohort study. The study included pregnant women with a confirmed diagnosis of HIV infection attending prenatal control visits and receiving care during delivery and the postpartum period, between January 2003 and December 2011 at the Simon Bolívar Hospital, a general, level-III referral centre for HIV patients, located in northwest Bogota. Sampling was done consecutively and the assessment included baseline social, demographic and clinical characteristics; maternal mortality during pregnancy, at the time of delivery and during the postpartum period; and perinatal mortality. A descriptive morbidity analysis was conducted using proportions, together with an exploratory analysis of the association between the CD4 lymphocyte count and viral load, and maternal and perinatal outcomes.
Results: Overall, 136 patients had a confirmed diagnosis of HIV at the institution, and complete information was obtained for 106 (78%) of them. There were no cases of maternal deaths and 2 foetal deaths in utero. The main maternal comorbidities found were anaemia (18%), STDs (22.6%), pneumonia (5.7%) and postpartum fever (4.7%). The most frequent perinatal comorbidities were low birth weight (21.7%), and seizures (2.8%). No association was found between viral load and CD4 count and maternal or perinatal morbidity.
Conclusion: Pregnant women with HIV infection generally present a slight increase in maternal and perinatal complications. It is important to undertake additional studies in different population groups in order to arrive at an appropriate evaluation of all these associations.
Author Biographies
Ana C. Gómez-Ríos
Mauricio E. Carrillo-Rozo
Jorge A. Rodríguez-Ortiz
References
Perfil Epidemiológico del VIH/Sida en Colombia 2012. Ministerio de la protección social. [Visitado 2014 nov 15]. Disponible en: http://www.minsalud.gov.co/salud/documents/observatorio_vih/documentos/monitoreo_evaluacion/1_vigilancia_salud_publica/a_situacion_epidimiologica/perfil_epidemiologico_vih_colombia_a2011_21mayo2012.pdf.
Ministerio de la Protección Social. Informe UNGASS, 2010. Colombia; 2012.
Kourtis AP, Bulterys M. Mother-to-Child Transmission of HIV: Pathogenesis, Mechanisms and Pathways. Clin Perinatol.2010;37:721-7.
Kuhn L, Aldrovandi G. Survival and Health Benefits of Breastfeeding Versus Artificial Feeding in Infants of HIV-Infected Women: Developing Versus Developed World. Clin Perinatol. 2010:37:843-62.
Mirpuri J, Jain L. Issues of Prematurity and HIV Infection. Clin Perinatol. 2010;37: 887-905.
Musana JW. Pregnancy outcomes in mothers with advanced human immunodeficiency virus disease. East Afr Med J. 2009;86:480-5.
Donovan M, Palumbo P. Diagnosis of HIV: Challenges and Strategies for HIV Prevention and Detection Among Pregnant Women and Their Infants. Clin Perinatol. 2010;37:751-3.
Louis J, Landon MB, Gersnoviez RJ, Leveno KJ, Spong CY, Rouse DJ, et al. Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery. Obstet Gynecol. 2007;110:385-90.
López M, Figueras F, Hernández S, Lonca M, García R, Palacio M, et al. Association of HIV infection with spontaneous and iatrogenic preterm delivery: effect of HAART. AIDS. 2012;26:37-43.
Williams SF, Keane-Tarchichi MH, Bettica L, Dieudonne A, Bardeguez AD, et al. Pregnancy outcomes in young women with perinatally acquired human immunodeficiency virus-1. Am J Obstet Gynecol. 2009;200:149.e1-5.
Traisathit P, Mary JY, Le Coeur S, Thantanarat S, Jungpichanvanich S, Pornkitprasarn W, et al. Risk factors of preterm delivery in HIV infected pregnant women receiving zidovudine for the prevention of perinatal HIV. J Obstet Gynaecol Res. 2009;35: 225-33.
Martin R, Boyer P, Hammill H, Peavy H, Platzker A, Settlage R, et al. Incidence of premature birth and neonatal respiratory disease in infants of HIV-positive mothers. The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Infection Study Group. J Pediatr. 1997;131:851-6.
Berkowits K, La Sala A. Risk Factors Associated with the Increasing Prevalence of Pneumonia during Pregnancy. Am J Obstet Gynecol. 1990;163:981-5.
Iglesias-Benavides JL, Tamez-Garza LE, Reyes- Fernández I. Anemia y embarazo, su relación con complicaciones maternas y perinatales. Medicina Universitaria. 2009;11:95-8.
Male D, Stockwell M, Jankowski S. Critical care in obstetric infections. Curr Obstet Gynecol. 2000;10:196-201.
Beck S, Wojdyla D, Say L, Betran A, Merialdi M, Requejo J, et al. Incidencia mundial de parto prematuro: revisión sistemática de la morbilidad y mortalidad maternas. Boletín de la Organización Mundial de la Salud. 2010;88:1-80.
Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin North Am. 2005;32:411-28.
Brocklehurst P, French R. The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis. Br J Obstet Gynaecol. 1998;105:836-48.
Tuntiseranee P, Olsen J, Chongsuvivatwong V, Limbutara S. Socioeconomic and work related determinants of pregnancy outcome in southern Thailand. J Epidemiol Community Health. 1999;53:624-9.
Glass HC, Wirrell E. Controversies in neonatal seizure management. Journal of Child Neurology. 2009;4:591-9.
Temmerman M, Chomba EN, Ndinya-Achola J, Plummer FA, Coppens M, Piot P. Maternal human immunodeficiency virus-1 infection and pregnancy outcome. Obstet Gynecol. 1994;83:495-501.
Suy A, Martínez E, Coll O, Lonca M, Palacio M, De Lazzari E, et al. Increased risk of pre-eclampsia and fetal death in HIV-infected pregnant women receiving highly active antiretroviral therapy. AIDS. 2006;20: 59-66.
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