American Journal of Epidemiology Vol. 147, No. 5: 434-440
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Pregnancy is Not Associated with the Progression of HIV Disease in Women Attending an HIV Outpatient Program
1Department of Biostatistics and Epidemiology, Tulane University School of Public Health and Tropical Medicine New Orleans, LA
2HIV Outpatient Program, Department of Medicine, Louisiana State University Medical Center New Orleans, LA
Reprint requests to Dr. Ruth Bessinger, Department of Biostatistics and Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Aye, SL-18, New Orleans, LA 70112.
3Present affiliation: Epidemiology and Statistics Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention Atlanta, GA.
The objective of this study was to determine whether pregnancy is associated with an acceleration of human immunodeficiency virus (HIV) disease progression in women who have a pregnancy while HIV infected. A retrospective review of all women aged 15–35 who attended an HIV outpatient program from January 1989 through August 1995, was undertaken. The 192 women who had a term pregnancy after testing positive for HIV were compared with 164 women who were not pregnant during the same period. The main outcome measures were death, the occurrence of a first acquired immunodeficiency syndrome (AIDS)-defining condition, or a condition indicative of symptomatic HIV. Disease progression was assessed using the Kaplan-Meier method and multivariate proportional hazards models. Compared with nonpregnant women, women with a term pregnancy were significantly more likely to be African-American (88% vs. 78%, p < 0.05), younger than 22 years of age (51% vs. 11%, p < 0.001). and to have entered the clinic with a higher median CD4 count (519 vs. 433 cells/µl, p < 0.001). After adjusting for entry CD4 count and other factors, pregnancy was not associated with progression to any of the study outcomes. Thus, in women attending a publicly funded clinic, pregnancy does not appear to accelerate the progression of HIV disease. Am J Epidemiol 1998; 147:434–40.
acquired immunodeficiency syndrome; blacks; disease progression; HIV; pregnancy; women
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