Document 0212
 DOCN  M9460212
 TI    Maternal human immunodeficiency virus-1 infection and pregnancy outcome.
 DT    9404
 AU    Temmerman M; Chomba EN; Ndinya-Achola J; Plummer FA; Coppens M; Piot P;
       Department of Medical Microbiology, University of Nairobi, Kenya.
 SO    Obstet Gynecol. 1994 Apr;83(4):495-501. Unique Identifier : AIDSLINE
       MED/94181199
 AB    OBJECTIVE: To study the impact of maternal human immunodeficiency virus
       type 1 (HIV-1) infection on pregnancy outcome. METHODS: Between January
       1989 and December 1991, 406 HIV-1-seropositive and 407
       HIV-1-seronegative age- and parity-matched pregnant women from Nairobi,
       Kenya, all at less than 28 weeks' gestation, were recruited into a
       prospective study of HIV-1 infection in pregnant women and their
       offspring. Both groups were followed until 6 weeks postpartum. RESULTS:
       Three hundred fifteen HIV-1-seropositive women and 311
       HIV-1-seronegative controls were followed until delivery. Seropositive
       women were younger at sexual debut and reported more lifetime partners
       and more sexually transmitted diseases (STDs) than the seronegative
       controls. The seropositive women had higher rates of genital ulcer
       disease (4.7 versus 2.0%; P = .08), genital warts (4.9 versus 2.0%; P =
       .03), and positive syphilis serology (7.9 versus 3.2%; P < .001), but
       there were no differences between the groups in isolation rates of
       Neisseria gonorrhoeae (6.8 versus 7.1%) and Chlamydia trachomatis (11.5
       versus 9.0%). Maternal HIV-1 infection was associated with significantly
       lower birth weight (2913 versus 3072 g; P = .0003) and with prematurity
       (21.1 versus 9.4%; P < .0001), but not with small for gestational age
       size (4.2 versus 3.2%; P = .7). The stillbirth rate was higher in
       seropositive women, yet not statistically significant (3.8 versus 1.9%;
       P = .2). Women with a CD4 count lower than 30% had a higher risk of
       preterm delivery (26.3 versus 10.1%; P < .001). Postpartum endometritis
       was more common in HIV-1-infected women than in seronegative controls
       (10.3 versus 4.2%; P = .01) and was inversely correlated with the CD4
       percentage. No histopathologic placental abnormalities attributable to
       HIV-1 were detected. CONCLUSION: Maternal HIV-1 infection was
       significantly associated with prematurity and postpartum endometritis,
       but not with fetal growth retardation. There was a trend toward a higher
       stillbirth rate in HIV-1-seropositive mothers.
 DE    *Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY  Adult  Female
       Follow-Up Studies  Human  *HIV Seropositivity/EPIDEMIOLOGY/IMMUNOLOGY
       *HIV-1  Leukocyte Count  Matched-Pair Analysis  Odds Ratio  Pregnancy
       *Pregnancy Complications, Infectious/EPIDEMIOLOGY/IMMUNOLOGY  *Pregnancy
       Outcome/EPIDEMIOLOGY  Prospective Studies  Risk Factors  Support,
       Non-U.S. Gov't  T4 Lymphocytes  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).