Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014

M. Ørbæk*, K. Thorsteinsson, E. Moseholm Larsen, T. L. Katzenstein, M. Storgaard, I. S. Johansen, G. Pedersen, D. Bach, M. Helleberg, N. Weis, A. M. Lebech

*Kontaktforfatter for dette arbejde

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Resumé

Objectives: We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) with those in women of the general population (WGP) in Denmark. Further, we estimated risk of pregnancy- or birth-related complications. Methods: A retrospective cohort study including all WLWH who delivered a live-born child from 2002 to 2014 and WGP, matched by origin, age, year and parity, was carried out. We compared risk factors during pregnancy and estimated risk of pregnancy- and birth-related complications using multivariate logistic regression. Results: A total of 2334 pregnancies in 304 WLWH and 1945 WGP were included in the study. WLWH had more risk factors present than WGP during pregnancy: previous caesarean section (CS) (24.7% versus 16.3%, respectively; P = 0.0001), smoking (14.2% versus 7.5%, respectively; P = 0.0001) and previous perinatal/neonatal death (2.3% versus 0.9%, respectively; P = 0.03). We found no difference between groups regarding gestational diabetes, hypertensive disorders, low birth weights or premature delivery. More children of WLWH had intrauterine growth retardation (IUGR) [adjusted odds ratio (aOR) 1.9; 95% confidence interval (CI) 1.1–3.2; P = 0.02]. Median gestational age and birth weight were lower in children born to WLWH. WLWH had a higher risk of emergency CS (EmCS) (aOR 1.6; 95% CI 1.2–2.1; P = 0.0005) and postpartum haemorrhage (aOR 1.4; 95% CI 1.0–1.9; P = 0.02) but not infection, amniotomy, failure to progress, low activity-pulse-grimace-appearance-respiration (APGAR) score or signs of asphyxia. Conclusions: WLWH had more risk factors present during pregnancy, similar risks of most pregnancy- and birth-related complications but a higher risk of postpartum haemorrhage and EmCS compared with WGP. Children born to WLWH had lower median birth weights and gestational ages and were at higher risk of IUGR.

OriginalsprogEngelsk
TidsskriftHIV Medicine
Vol/bind21
Udgave nummer2
Sider (fra-til)84-95
ISSN1464-2662
DOI
StatusUdgivet - feb. 2020

Fingeraftryk

Denmark
HIV
Postpartum Hemorrhage
Fetal Growth Retardation
Population
Odds Ratio
Confidence Intervals
Gestational Age
Emergencies
Gestational Diabetes
Low Birth Weight Infant
Parity
Respiration
Cohort Studies
Retrospective Studies
Logistic Models
Smoking

Citer dette

Ørbæk, M., Thorsteinsson, K., Moseholm Larsen, E., Katzenstein, T. L., Storgaard, M., Johansen, I. S., ... Lebech, A. M. (2020). Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014. HIV Medicine, 21(2), 84-95. https://doi.org/10.1111/hiv.12798
Ørbæk, M. ; Thorsteinsson, K. ; Moseholm Larsen, E. ; Katzenstein, T. L. ; Storgaard, M. ; Johansen, I. S. ; Pedersen, G. ; Bach, D. ; Helleberg, M. ; Weis, N. ; Lebech, A. M. / Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014. I: HIV Medicine. 2020 ; Bind 21, Nr. 2. s. 84-95.
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title = "Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014",
abstract = "Objectives: We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) with those in women of the general population (WGP) in Denmark. Further, we estimated risk of pregnancy- or birth-related complications. Methods: A retrospective cohort study including all WLWH who delivered a live-born child from 2002 to 2014 and WGP, matched by origin, age, year and parity, was carried out. We compared risk factors during pregnancy and estimated risk of pregnancy- and birth-related complications using multivariate logistic regression. Results: A total of 2334 pregnancies in 304 WLWH and 1945 WGP were included in the study. WLWH had more risk factors present than WGP during pregnancy: previous caesarean section (CS) (24.7{\%} versus 16.3{\%}, respectively; P = 0.0001), smoking (14.2{\%} versus 7.5{\%}, respectively; P = 0.0001) and previous perinatal/neonatal death (2.3{\%} versus 0.9{\%}, respectively; P = 0.03). We found no difference between groups regarding gestational diabetes, hypertensive disorders, low birth weights or premature delivery. More children of WLWH had intrauterine growth retardation (IUGR) [adjusted odds ratio (aOR) 1.9; 95{\%} confidence interval (CI) 1.1–3.2; P = 0.02]. Median gestational age and birth weight were lower in children born to WLWH. WLWH had a higher risk of emergency CS (EmCS) (aOR 1.6; 95{\%} CI 1.2–2.1; P = 0.0005) and postpartum haemorrhage (aOR 1.4; 95{\%} CI 1.0–1.9; P = 0.02) but not infection, amniotomy, failure to progress, low activity-pulse-grimace-appearance-respiration (APGAR) score or signs of asphyxia. Conclusions: WLWH had more risk factors present during pregnancy, similar risks of most pregnancy- and birth-related complications but a higher risk of postpartum haemorrhage and EmCS compared with WGP. Children born to WLWH had lower median birth weights and gestational ages and were at higher risk of IUGR.",
keywords = "birth complications, caesarean section, intrauterine growth retardation, pregnancy, preterm delivery, risk factors, women living with HIV",
author = "M. {\O}rb{\ae}k and K. Thorsteinsson and {Moseholm Larsen}, E. and Katzenstein, {T. L.} and M. Storgaard and Johansen, {I. S.} and G. Pedersen and D. Bach and M. Helleberg and N. Weis and Lebech, {A. M.}",
year = "2020",
month = "2",
doi = "10.1111/hiv.12798",
language = "English",
volume = "21",
pages = "84--95",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell",
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Ørbæk, M, Thorsteinsson, K, Moseholm Larsen, E, Katzenstein, TL, Storgaard, M, Johansen, IS, Pedersen, G, Bach, D, Helleberg, M, Weis, N & Lebech, AM 2020, 'Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014', HIV Medicine, bind 21, nr. 2, s. 84-95. https://doi.org/10.1111/hiv.12798

Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014. / Ørbæk, M.; Thorsteinsson, K.; Moseholm Larsen, E.; Katzenstein, T. L.; Storgaard, M.; Johansen, I. S.; Pedersen, G.; Bach, D.; Helleberg, M.; Weis, N.; Lebech, A. M.

I: HIV Medicine, Bind 21, Nr. 2, 02.2020, s. 84-95.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Risk factors during pregnancy and birth-related complications in HIV-positive versus HIV-negative women in Denmark, 2002–2014

AU - Ørbæk, M.

AU - Thorsteinsson, K.

AU - Moseholm Larsen, E.

AU - Katzenstein, T. L.

AU - Storgaard, M.

AU - Johansen, I. S.

AU - Pedersen, G.

AU - Bach, D.

AU - Helleberg, M.

AU - Weis, N.

AU - Lebech, A. M.

PY - 2020/2

Y1 - 2020/2

N2 - Objectives: We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) with those in women of the general population (WGP) in Denmark. Further, we estimated risk of pregnancy- or birth-related complications. Methods: A retrospective cohort study including all WLWH who delivered a live-born child from 2002 to 2014 and WGP, matched by origin, age, year and parity, was carried out. We compared risk factors during pregnancy and estimated risk of pregnancy- and birth-related complications using multivariate logistic regression. Results: A total of 2334 pregnancies in 304 WLWH and 1945 WGP were included in the study. WLWH had more risk factors present than WGP during pregnancy: previous caesarean section (CS) (24.7% versus 16.3%, respectively; P = 0.0001), smoking (14.2% versus 7.5%, respectively; P = 0.0001) and previous perinatal/neonatal death (2.3% versus 0.9%, respectively; P = 0.03). We found no difference between groups regarding gestational diabetes, hypertensive disorders, low birth weights or premature delivery. More children of WLWH had intrauterine growth retardation (IUGR) [adjusted odds ratio (aOR) 1.9; 95% confidence interval (CI) 1.1–3.2; P = 0.02]. Median gestational age and birth weight were lower in children born to WLWH. WLWH had a higher risk of emergency CS (EmCS) (aOR 1.6; 95% CI 1.2–2.1; P = 0.0005) and postpartum haemorrhage (aOR 1.4; 95% CI 1.0–1.9; P = 0.02) but not infection, amniotomy, failure to progress, low activity-pulse-grimace-appearance-respiration (APGAR) score or signs of asphyxia. Conclusions: WLWH had more risk factors present during pregnancy, similar risks of most pregnancy- and birth-related complications but a higher risk of postpartum haemorrhage and EmCS compared with WGP. Children born to WLWH had lower median birth weights and gestational ages and were at higher risk of IUGR.

AB - Objectives: We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) with those in women of the general population (WGP) in Denmark. Further, we estimated risk of pregnancy- or birth-related complications. Methods: A retrospective cohort study including all WLWH who delivered a live-born child from 2002 to 2014 and WGP, matched by origin, age, year and parity, was carried out. We compared risk factors during pregnancy and estimated risk of pregnancy- and birth-related complications using multivariate logistic regression. Results: A total of 2334 pregnancies in 304 WLWH and 1945 WGP were included in the study. WLWH had more risk factors present than WGP during pregnancy: previous caesarean section (CS) (24.7% versus 16.3%, respectively; P = 0.0001), smoking (14.2% versus 7.5%, respectively; P = 0.0001) and previous perinatal/neonatal death (2.3% versus 0.9%, respectively; P = 0.03). We found no difference between groups regarding gestational diabetes, hypertensive disorders, low birth weights or premature delivery. More children of WLWH had intrauterine growth retardation (IUGR) [adjusted odds ratio (aOR) 1.9; 95% confidence interval (CI) 1.1–3.2; P = 0.02]. Median gestational age and birth weight were lower in children born to WLWH. WLWH had a higher risk of emergency CS (EmCS) (aOR 1.6; 95% CI 1.2–2.1; P = 0.0005) and postpartum haemorrhage (aOR 1.4; 95% CI 1.0–1.9; P = 0.02) but not infection, amniotomy, failure to progress, low activity-pulse-grimace-appearance-respiration (APGAR) score or signs of asphyxia. Conclusions: WLWH had more risk factors present during pregnancy, similar risks of most pregnancy- and birth-related complications but a higher risk of postpartum haemorrhage and EmCS compared with WGP. Children born to WLWH had lower median birth weights and gestational ages and were at higher risk of IUGR.

KW - birth complications

KW - caesarean section

KW - intrauterine growth retardation

KW - pregnancy

KW - preterm delivery

KW - risk factors

KW - women living with HIV

U2 - 10.1111/hiv.12798

DO - 10.1111/hiv.12798

M3 - Journal article

C2 - 31603598

AN - SCOPUS:85074050153

VL - 21

SP - 84

EP - 95

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 2

ER -