Inclusion flowchart.

<div><p>Introduction</p><p>In utero exposure to HIV and/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adve...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Natalia Zotova (2463763) (author)
مؤلفون آخرون: Athanase Munyaneza (10171817) (author), Gad Murenzi (6243719) (author), Gallican Kubwimana (10171823) (author), Adebola Adedimeji (3637168) (author), Kathryn Anastos (119435) (author), Marcel Yotebieng (349839) (author)
منشور في: 2025
الموضوعات:
الوسوم: إضافة وسم
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الوصف
الملخص:<div><p>Introduction</p><p>In utero exposure to HIV and/or antiretroviral therapy (ART) has been shown to be associated with stillbirth, preterm births, and low birth weight (LBW), but data from low-resource, high- HIV-burden settings remain limited. This study describes adverse pregnancy outcomes among Rwandan women living with HIV (WLWH) and HIV-uninfected women and examines associations between HIV, ART timing, and LBW.</p><p>Methods</p><p>This retrospective cohort study used antenatal care, delivery, and PMTCT registry data from the Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA). Women with documented HIV status and recorded birth weights were included. Adverse outcomes were defined as LBW (<2,500 g), stillbirth, and preterm birth (<37 weeks gestation). Logistic regression was used to assess associations between maternal HIV status, ART timing, and LBW, adjusting for relevant covariates.</p><p>Results and discussion</p><p>Among 10,191 women with known HIV status and babies’ birth weights, 12.7% (n = 1,293) were WLWH. There were 47 stillbirths (0.5%) and 70 preterm births (0.7%). Among 10,037 term births, 366 (3.6%) were LBW. WLWH had significantly higher rates of stillbirth (0.6% vs. 0.4%, p < 0.05) and LBW (6.5% vs. 2.9%, p < 0.001) compared to HIV-uninfected women; preterm birth rates did not differ significantly. The adjusted odds of LBW among WLWH were 1.61 (95% CI: 1.08, 2.39), controlling for marital status, primigravidae, and maternal weight at admission. Among WLWH (n = 1,274), ART initiation prior to pregnancy was associated with 50% lower odds of LBW after adjusting for age and WHO stage.</p><p>Conclusions</p><p>Even among relatively healthy uncomplicated pregnancies in low-risk delivery settings and universal ART, WLWH experienced significantly higher rates of stillbirth and LBW. Among WLWH, initiation of ART prior to current pregnancy had a protective effect against LBW. This underscores the importance of early HIV diagnosis and initiation of ART.</p></div>