scholarly journals Prenatal Ultrasound Screening for Fetal Anomalies and Outcomes in High-Risk Pregnancies due to Maternal HIV Infection: A Retrospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
A. Reitter ◽  
A. U. Stücker ◽  
H. Buxmann ◽  
E. Herrmann ◽  
A. E. Haberl ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Prenatal Screening ◽  
First Trimester ◽  
Prenatal Ultrasound ◽  
Ultrasound Screening ◽  
Prenatal Ultrasonography ◽  
Neonatal Deaths ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

Objective. To assess the prevalence of prenatal screening and of adverse outcome in high-risk pregnancies due to maternal HIV infection.Study Design. The prevalence of prenatal screening in 330 pregnancies of HIV-positive women attending the department for prenatal screening and/or during labour between January 1, 2002 and December 31, 2012, was recorded. Screening results were compared with the postnatal outcome and maternal morbidity, and mother-to-child transmission (MTCT) was evaluated.Results. One hundred of 330 women (30.5%) had an early anomaly scan, 252 (74.5%) had a detailed scan at 20–22 weeks, 18 (5.5%) had a detailed scan prior to birth, and three (0.9%) had an amniocentesis. In seven cases (2.12%), a fetal anomaly was detected prenatally and confirmed postnatally, while in eight (2.42%) an anomaly was only detected postnatally, even though a prenatal scan was performed. There were no anomalies in the unscreened group. MTCT occurred in three cases (0.9%) and seven fetal and neonatal deaths (2.1%) were reported.Conclusion. The overall prevalence of prenatal ultrasound screening in our cohort is 74.5%, but often the opportunity for prenatal ultrasonography in the first trimester is missed. In general, the aim should be to offer prenatal ultrasonography in the first trimester in all pregnancies. This allows early reassurance or if fetal disease is suspected, further steps can be taken.

scholarly journals Maternal HIV infection is associated with distinct systemic cytokine profiles throughout pregnancy in South African women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charlene Akoto ◽  
Shane A. Norris ◽  
Joris Hemelaar
Keyword(s):  
Hiv Infection ◽  
First Trimester ◽  
African Women ◽  
Cytokine Profiles ◽  
Women Living With Hiv ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Adverse Pregnancy ◽  
South African Women ◽  
Hiv Negative

AbstractMaternal HIV infection is associated with adverse pregnancy outcomes, but the mechanisms remain unknown. The course of pregnancy is regulated by immunological processes and HIV infection and antiretroviral therapy (ART) impact key immune mechanisms, which may disrupt the immune programme of pregnancy. We evaluated a broad range of systemic cytokines at each trimester of pregnancy in 56 women living with HIV (WLHIV) and 68 HIV-negative women, who were enrolled in a prospective pregnancy cohort study in Soweto, South Africa. The pro-inflammatory cytokine IP-10 was detected in each trimester in all WLHIV, which was significantly more than in HIV-negative women. The anti-viral cytokine IFNλ1 was detected more frequently in WLHIV, whereas IFNβ and IFNλ2/3 were detected more frequently in HIV-negative women. Th1 cytokines IL-12 and IL-12p70, Th2 cytokine IL-5, and Th17 cytokine IL-17A were detected more frequently in WLHIV throughout pregnancy. Il-6, IL-9, and IL-10 were more commonly detected in WLHIV in the first trimester. Trends of increased detection of Th1 (IL-2, IL-12p70), Th2 (IL-4, Il-5, Il-13) and Th17 (IL-17A, Il-17F, IL-21, IL-22) cytokines were associated with small-for-gestational-age babies. Our findings indicate that maternal HIV/ART is associated with distinct systemic cytokine profiles throughout pregnancy.

The impact of maternal HIV infection on parenting in inner-city African American families.

1997 ◽  
Vol 11 (4) ◽  
pp. 447-461 ◽  
Author(s):  
Beth A. Kotchick ◽  
Rex Forehand ◽  
Gene Brody ◽  
Lisa Armistead ◽  
Patricia Simon ◽  
...  
Keyword(s):  
African American ◽  
Hiv Infection ◽  
Inner City ◽  
African American Families ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
The Impact ◽  
American Families

Maternal HIV infection and spontaneous versus provider-initiated preterm birth in an urban Zambian cohort

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Joan T PRICE ◽  
Bellington VWALIKA ◽  
Jessie K EDWARDS ◽  
Stephen R COLE ◽  
Margaret P KASARO ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Hiv Infection ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

scholarly journals Obstetric and new born outcome in HIV infected pregnant women: a prospective cohort study in Bangalore Medical College Hospitals, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4445
Author(s):  
Rashmi S. Desai ◽  
Geetha Shivamurthy ◽  
Sameer Desai
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Opportunistic Infection ◽  
Prospective Cohort ◽  
Premature Rupture ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Cd4 Cell

Background: The effect of HIV on obstetric complications is known to vary across regions of world. The variation may be due to HIV infection per se or it may be due to complex interaction of related medical and social conditions that affect pregnancy. Incidence of these obstetric complications in HIV infected pregnant women is not well reported in India. So, this prospective cohort study was carried to observe the demographics and incidence of obstetrics complications like abortions, still birth, premature rupture of membranes, preterm delivery, opportunistic infections in HIV infected pregnant women.Methods: All pregnant women who were screened positive for HIV test, irrespective of their gestational age were included in the study. Apart from routine obstetric care, CD4 cell count was carried out. The patients were followed up till term, delivery and up to 6-week postpartum period. Obstetric outcomes like incidence of abortion, intrauterine death, preterm delivery and premature rupture of membrane were noted. Baby`s birth weight and the incidence of maternal opportunistic infection were noted and correlated with maternal CD4 cell count.Results: Maternal HIV infection is associated pre-term labour in 34.5%, PROM in 30%, low birth weight in 52.3%. Increased incidences of these adverse outcomes have an inverse relationship with CD4 count.Conclusions: Maternal HIV infection is associated with increased incidence of adverse obstetric outcome and opportunistic infection, and their incidences increase with lower CD4 count.

scholarly journals Causal Effect of Maternal HIV on Child Health Outcomes in the Context of Prevention of Mother to Child HIV Transmission (PMTCT) in Malawi

2019 ◽  
Author(s):  
Halima Sumayya Twabi ◽  
Samuel O Manda ◽  
Dylan S Small
Keyword(s):  
Birth Weight ◽  
Propensity Score ◽  
Hiv Infection ◽  
Exclusive Breastfeeding ◽  
Causal Effect ◽  
Mediating Effect ◽  
Pmtct Program ◽  
Hiv Status ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

Abstract Evidence has shown that maternal HIV infection has adverse effects on child birth weight. However, the effect of anti-retroviral therapy (ART) on pregnancy outcome is not conclusive. Ascertaining causality of these associations remain largely unexamined and untested, and if confirmed would help policy makers to improve implementation and sensitization of PMTCT program. However, assessing causal effect has been limited due to ethical concerns if randomized controlled trials are appropriate. We aim to estimate the causal effect of maternal HIV on birth weight and the causal effect of knowledge of HIV status on exclusive breastfeeding while ascertaining the mediating effect of ART using observational data. Data on over 18,000 and 16,000 children still alive and born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys were analysed. A set of methods for confounder balance namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting the propensity score (PS) were used. Before matching, place of residence, region, anaemia level and age were statistically different between HIV-infected and HIV-uninfected mothers for both the 2010 and 2015-16 data. After matching, the selected confounding variables were distributed similarly between HIV-infection statuses. Maternal HIV infection had a negative effect on infant birth weight for the 2010 data and had a positive effect on birth weight for the 2015-16 data with p-values <0.001. Uptake of ART did not mediate the effect of HIV infection on birth weight. Maternal knowledge of HIV status was not associated with behaviour concerning exclusive breastfeeding. We have found conflicting evidence on the association between maternal HIV infection and birth weight. The adverse association between maternal HIV infection and child birth weight found for the 2010 data could more likely be causal. However, the increased birth weight among infants born to HIV infected mothers in 2015-16 may show the recent successes of policies and interventions within the PMTCT program in Malawi. However, the purported mediating effect of ART on the association between HIV infection and birth weight was not found. Prenatal care interventions should continue to be supported among ANC clinics in Malawi.

Impact of maternal HIV infection on obstetrical and early neonatal outcome

AIDS ◽  
1990 ◽  
Vol 4 (10) ◽  
pp. 1001-1006 ◽  
Author(s):  
Michael R. Braddick ◽  
Joan K. Kreiss ◽  
Joanne E. Embree ◽  
Pratibha Datta ◽  
Jack O. Ndinya-Achola ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Neonatal Outcome ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

Localization of Human Immunodeficiency Virus Core Antigen in Term Human Placentas

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 207-209
Author(s):  
Carl F. T. Mattern ◽  
Karen Murray ◽  
Allison Jensen ◽  
Homayoon Farzadegan ◽  
Jenny Pang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Mononuclear Cells ◽  
Morphological Characteristics ◽  
Core Antigen ◽  
Hiv Replication ◽  
Immunodeficiency Virus ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Seropositive

Evidence of human immunodeficiency virus (HIV) replication was sought in human placentas obtained at term from pregnancies complicated by maternal HIV infection. Placentas were obtained from the pregnancies of 19 HIV-seropositive women, 4 women who were seronegative, and 4 untested women with no risk factors for HIV infection. These placentas were each examined by immunoperoxidase immunocytochemistry using monoclonal anti-p24/55 antibodies. In addition, minced placental tissue from 11 of the seropositive pregnancies and the 3 seronegative pregnancies were co-cultivated with stimulated human peripheral blood mononuclear cells. The clinical status of the infants born to the HIV-seropositive women was assessed when the infants were 8 to 28 months of age. P24/55 antigen was detected in 5 of the 19 placentas of the HIV-seropositive pregnancies and in none of the 8 placentas of seronegative or low-risk pregnancies. This HIV core viral antigen was located exclusively in the cytoplasm of villous cells with morphological characteristics of macrophages. The HIV antigen-containing cells were very sparsely distributed. Staining of the trophoblast was not observed in any placental specimen. Human immunodeficiency virus was isolated in culture from 3 of the 11 placentas from seropositive pregnancies. Clinical follow-up has not revealed a relationship between infection of the infant and either p24/55 antigen identification or isolation of virus from the placenta. Virological and histological evidence of HIV replication is found in approximately one fourth of placentas obtained at term from pregnancies complicated by maternal HIV infection. Replicating virus appears localized to sparse macrophages located within the chorionic villi, but specifically not within the trophoblastic layer. It is unlikely that identification of HIV in the placenta either by culture or by immunocytochemistry will predict infection of infants born to seropositive women.

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