Human Immunodeficiency Virus in Pregnancy a Retrospective Study on Maternal and Perinatal Outcomes

  • Nambiar Murlikrishnan Meenakshiamma memorial hospital
  • Shetty Nikil Kasturba medical college, Mangalore
  • Athulya sreenivas
  • Anupama Suresh Kasturba medical college, Mangalore
  • Anjali Mundkur


Objective:  To assess the maternal and perinatal outcome in pregnant women with HIV infection and the role of Antiretroviral therapy in reducing complications of pregnancy.

Methods: A retrospective analysis was conducted on data from HIV-positive mothers receiving antenatal care at a tertiary care center between February 2015 and January 2020. The study examined various adverse pregnancy outcomes in relation to antiretroviral treatment. Statistical analysis employed chi-square and Fisher’s exact tests to determine differences in distribution proportions of patients on ART versus those not on ART across various antenatal and neonatal complications, with significance attributed to p-values <0.05.

Results: A total of 155 patients were found to be HIV positive. Out of this 58 were diagnosed before pregnancy and 97 during pregnancy. Miscarriage was seen in one (0.6%) patient on ART and two (1.2%) not on treatment (p-value 0.6). Sixteen (10.3%) patients underwent medical termination of pregnancy (MTP); all were given HIV-positive status and they were all on ART (p-value <0.001). Anemia was seen in eighteen (11.6%) patients out of which 14(9%) were on ART (p-value 0.01). One (0.64%) woman had thrombocytopenia and she was on ART (p-value 1). Two (1.2%) patients on ART had diabetes mellitus (p-value 0.4). One (0.64%) patient who was on ART developed polyhydramnios (p-value 1).  A total of 8 (5.16%) women had hypertensive disorders; out of which 4(2.58%) were on ART (p-value 1). 11(7.09%) patients who were on ART and 6(3.8%) not on ART had preterm labor (p-value 0.2). 12(7.74%) patients who were not on ART had intrauterine growth restriction (IUGR) and 2(1.29%) on ART had IUGR. A total of 6(3.87%) patients had Intrauterine fetal demise (IUFD), of which 3(1.93%) were on ART and 3(1.93%) were not (p-value 1).  Pre-labour rupture of membranes (PROM) was observed in 2(1.29%) women on ART and 11(7.09%) patients not on ART (p-value 0.004). All women (100%) had CD4 counts more than 500. All (100%) babies delivered at our center received antiretroviral therapy either with oral Nevirepine. Almost half the women (51.6%) had vaginal delivery. Almost one-fourth, 41(26.4%) had a cesarean section. All caesareans were done given obstetric indications. There were no instrumental deliveries. Our study had a total of 122 live births. All 122(100%) babies were exclusively breastfed. None of the babies delivered in our center developed HIV on follow up which was done at 6 weeks and 6 months. Nine (5.8%) patients had infections. None of these women were on ART(p-value < 0.001).

Conclusion: HIV infection during pregnancy is associated with various adverse outcomes, but ART plays a crucial role in mitigating these risks and preventing mother-to-child HIV transmission. Initiating ART in all HIV-positive mothers and their infants is essential regardless of HIV status.

Keywords: anemia, ART, HIV, MTP, Perinatal outcome,  PROM.


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Author Biographies

Nambiar Murlikrishnan, Meenakshiamma memorial hospital

MBBS, MRCOG(UK), DGO,MS(OBG) Consultant gynecologist ,obstetrician and laparoscopic surgeon , Meenakshiamma memorial hospital , Payyanur, Kerala ,India

Shetty Nikil, Kasturba medical college, Mangalore

Associate profesor , Department of obstetrics and gynecology , KMC Mangalore

Athulya sreenivas

MBBS, MS(ENT), Consultant and chief of research cell, Department of ENT and head and neck surgery, Meenakshiamma memorial hospital, Payyanur, Kerala, India

Anupama Suresh, Kasturba medical college, Mangalore

MBBS, DGO, DNB, Professor , Department of OBG, KMC Mangalore

Anjali Mundkur

MBBS, MRCOG, MS(OBG), Assocaite professor, Department of OBG, KMC Manipal

Research Article