Meconium aspiration syndrome in infants of HIV-positive women: a case-control study

2016 ◽  
Vol 44 (4) ◽  
Author(s):  
Sachin K. Gupta ◽  
Pam Haerr ◽  
Richard David ◽  
Alok Rastogi ◽  
Suma Pyati

AbstractOur aim was to determine whether maternal HIV infection in the current era is associated with an increased incidence of meconium aspiration syndrome (MAS) in their infants.Infants born to 149 HIV-positive women at our hospital over a 5-year period were compared with infants born to HIV-negative women in a retrospective case-control study. Charts of all 298 patients included in the study were reviewed for maternal and infant demographics, HIV treatment, vertical transmission and untoward events at delivery or during the hospital course.When compared with HIV-negative women, a greater proportion of HIV-positive women had meconium-stained amniotic fluid (MSAF), 33% vs. 13%, P<0.001; and thick MSAF, 17% vs. 5%, P<0.001, respectively. Seven of 298 infants were admitted to the neonatal intensive care unit for MAS; all seven were born to HIV-positive women (P=0.015). AlthoughInfants born to HIV-positive women had significantly more MSAF and MAS than infants born to non-infected women. It is unclear whether this association results from maternal HIV infection itself or from anti-retroviral therapy. Maternal and infant care providers should be prepared for this complication when attending to the deliveries of HIV-positive women.

2020 ◽  
Vol 14 (08) ◽  
pp. 901-907
Author(s):  
Tung-Che Hung ◽  
Li-Cheng Lu ◽  
Mei-Hui Lin ◽  
Yu-Chia Hu ◽  
Chien-Yu Cheng ◽  
...  

Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well. Results: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV. Conclusions: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.


2016 ◽  
Author(s):  
Edwin Walong ◽  
Christopher Gontier ◽  
Walter Jaoko ◽  
Elizabeth Bukusi

ABSTRACTBackgroundUse of the progestin contraceptive Depot Medroxyprogesterone Acetate (DMPA) by HIV 1 infected women is associated with increased female to male transmission of HIV. Mucosal innate immune activation has been proposed as a likely mechanism. To establish the effect of DMPA upon mucosal immune activation, this study sought to evaluate the concentrations of 5 proinflammatory and the regulatory cytokine IL 10 in cervicovaginal lavage fluid.MethodsThis was a case control study, 70 participants were recruited, comprising of 35 asymptomatic ART naïve HIV positive women on DMPA recruited as cases and 35 age matched asymptomatic ART naive HIV positive women not on contraceptives recruited as controls. Peripheral blood CD4 and total lymphocyte counts, High vaginal swab microscopy, endocervical smears and cervical cytology were performed for each participant. Concentrations of six proinflammatory cytokines were measured on cervicovaginal lavage by multiplex cytometric bead array.ResultsThe mean age of cases was 26.8 years and 30 years for controls. Total lymphocyte counts and CD4 cell counts were significantly higher among cases (p=0.02 and 0.004 respectively). HSV 2 prevalence as determined by ELISA was higher (p=0.034 among cases. The concentrations of the cytokines IL 1β, IL 6, IL 8, IL 12p70 and TNF α were lower among cases, with IL 1β being statistically significant (p=0.046). Concentrations of IL 10 was higher among cases (p=0.022). On multivariate analysis, reduction in IL 1β and IL 8 were associated with the duration of DMPA use (p=0.015 and 0.041 respectively). Inclusion of HSV 2 into the multivariate models showed elevation of all cytokines measured (p=<0.001).ConclusionDMPA use is associated with reduction of proinflammatory cytokines and elevation of the regulatory cytokine IL 10. This may explain increased female to male transmission of HIV infection by modulation of male genital tract mucosa in the absence of increased HIV 1 genital shedding.


2017 ◽  
Vol 16 (2) ◽  
pp. 3-9
Author(s):  
Kavita Karmacharya ◽  
Rajiv Batra ◽  
Subramaniam Kandasamy

Introduction: HPV is a known cause of abnormal cervical cytology and cervical cancer. The prevalence of cervical cancer among HIV infected women is higher. This study compared the prevalence of HPV and abnormal cervical cytology between HIV positive and negative females.Methods: In this case-control study, 100 consecutive HIV-positive females were included as cases and 75 HIV-negative females were taken as controls. Cervical smears and scrapes were taken for Pap smear and HPV DNA by PCR and compared.Results: Prevalence of HPV among HIV-positive females (35%; n=35) was higher than HIV-negatives (8%; n=6) and was statistically significant (<0.05). The incidence of LSIL, HSIL and ASCUS in the HIV-positive was 16%, 3%, 2% respectively and 5%, 2.5%, 1.3% respectively in the HIV-negative. LSIL lesion showed statistical significance (p <0.05) but HSIL and ASCUS lesions had no such significance (p values 0.65 and 0.56 respectively).Conclusions: A strong correlation was found between HPV positivity and abnormal cervical lesions diagnosed on cytology, especially among the HIV positive population especially LSILs. Therefore, screening of cervical cancer should include HPV identification and cervical cytology, especially among HIV positive women, so that prompt and appropriate treatment of HIV would help in reducing the prevalence of cervical cancer.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110261
Author(s):  
Gizachew Abdissa Bulto ◽  
Daniel Belema Fekene ◽  
Benyam Seifu Woldeyes ◽  
Bikila Tefera Debelo

Background. Neonatal sepsis is the cause of substantial morbidity and mortality, mostly affecting the developing countries including Ethiopia. Previously conducted studies also highlighted the high prevalence of neonatal sepsis in Ethiopia. Therefore, this study was aimed at assessing the determinants of neonatal sepsis in the central Ethiopia. Method. Institution based un-matched case control study was conducted among 192 cases (neonates with sepsis) and 384 controls (without sepsis) in public hospitals in Central Ethiopia. The data were collected through face-to-face interview using structured questionnaire and extraction from maternal and neonatal charts. Binary logistic regression (bi-variable and multi-variable) model was fitted. Adjusted odds ratio with respect to 95% confidence interval was employed for the strength and directions of the association. Results. Younger maternal-age; 30 to 34 years (AOR = 0.41, 95%CI: 0.19-0.85) and 25 to 29 years (AOR = 0.38, 95%CI: 0.17-0.84), not having antenatal care (ANC) follow-ups (AOR = 1.89, 95%CI: 1.02-3.49), place of delivery; home (AOR = 12.6, 95%CI: 5.32-29.82) and health center (AOR = 2.74, 95%CI: 1.7, 4.41), prolonged duration of labor (AOR = 1.90, 95%CI: 1.22, 2.96), prolonged rupture of membrane 12 to 17 hours (AOR = 3.26, 95%CI: 1.46, 7.26) and ≥18 hours (AOR = 5.18, 95%CI: 1.98, 13.55) were maternal related determinants of neonatal sepsis. Whereas, prematurity (AOR = 2.74, 95%CI: 1.73, 4.36), being resuscitated (AOR = 1.93, 95%CI: 1.22, 3.06) and not having meconium aspiration syndrome (AOR = 2.55, 95%CI: 1.34, 4.83) were identified as neonatal related determinants of neonatal sepsis. Conclusion. Younger maternal age, not having antenatal care follow-up, home, and health center delivery, prolonged duration of labor, prolonged duration of rupture of membrane, prematurity, had resuscitation, and neonates without meconium aspiration syndrome were found to be determinants of neonatal sepsis. Therefore, the concerned stakeholders should consider those identified determinants during an intervention for improvement of neonatal health.


2017 ◽  
Vol 2 ◽  
pp. 103 ◽  
Author(s):  
Hannah R. Jary ◽  
Stephen Aston ◽  
Antonia Ho ◽  
Emanuele Giorgi ◽  
Newton Kalata ◽  
...  

Background:Four million people die each year from diseases caused by exposure to household air pollution. There is an association between exposure to household air pollution and pneumonia in children (half a million attributable deaths a year); however, whether this is true in adults is unknown. We conducted a case-control study in urban Malawi to examine the association between exposure to household air pollution and pneumonia in adults.Methods:Hospitalized patients with radiologically confirmed pneumonia (cases) and healthy community controls underwent 48 hours of ambulatory and household particulate matter (µg/m3) and carbon monoxide (ppm) exposure monitoring. Multivariate logistic regression, stratified by HIV status, explored associations between these and other potential risk factors with pneumonia.Results:145 (117 HIV-positive; 28 HIV-negative) cases and 253 (169 HIV-positive; 84 HIV-negative) controls completed follow up. We found no evidence of association between household air pollution exposure and pneumonia in HIV-positive (e.g. ambulatory particulate matter adjusted odds ratio [aOR] 1.00 [95% CI 1.00–1.01, p=0.141]) or HIV-negative (e.g. ambulatory particulate matter aOR 1.00 [95% CI 0.99–1.01, p=0.872]) participants. Chronic respiratory disease was associated with pneumonia in both HIV-positive (aOR 28.07 [95% CI 9.29–84.83, p<0.001]) and HIV-negative (aOR 104.27 [95% CI 12.86–852.35, p<0.001]) participants.Conclusions:We found no evidence that exposure to household air pollution is associated with pneumonia in Malawian adults. In contrast, chronic respiratory disease was strongly associated with pneumonia.


2016 ◽  
Vol 37 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Indiara Welter Henn ◽  
Ruann Oswaldo Carvalho da Silva ◽  
Cassiano Lima Chaiben ◽  
Ângela Fernandes ◽  
Maria Ângela Naval Machado ◽  
...  

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