scholarly journals Impact of antiretroviral therapy on pregnancy outcomes

2013 ◽  
Vol 14 (4) ◽  
pp. 176-178 ◽  
Author(s):  
C D Aniji ◽  
Olakunle A Towobola ◽  
Muhammad Ehsanul Hoque ◽  
T J Mashamba ◽  
Sam Monokoane
Keyword(s):  
Antiretroviral Therapy ◽  
Preterm Delivery ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Mixed Data ◽  
Art Initiation ◽  
Hiv Positive Women ◽  
The Impact

Background.The majority of HIV-positive women in South Africa are of reproductive age, and pregnancies among women using antiretroviral therapy (ART) are common. However, there are mixed data regarding the impact of ART on pregnancy outcomes.Objective. To examine the impact of ART on pregnancy outcome according to the timing of initiation of treatment.Methods. A retrospective cohort study was conducted among women delivering at a tertiary hospital from 1 October 2008 to 31 March 2009.Results. A total of 245 mothers were receiving ART: 76 mothers (31%) started ART pre-conception and 169 mothers (69%) started ART after the first trimester. No significant differences were observed in the rates of preterm delivery and low birth weight (LBW) between the pre- and post-conception groups (21% v. 24% and 21% v. 25%, respectively).Conclusion. In this cohort of women receiving ART in pregnancy, timing of ART initiation did not have any adverse effect on the measured pregnancy outcomes such as preterm delivery and LBW.

Fertility desire and associated factors among ART user reproductive-age women in public health facility in Gondar city administration Northwest Ethiopia

2020 ◽  
Author(s):  
Eyob Araya Gebrekidan ◽  
Alehegn Bishaw Geremew ◽  
Telake Azale Bisetegn
Keyword(s):  
Health Care ◽  
Antiretroviral Therapy ◽  
Associated Factors ◽  
Reproductive Age ◽  
Family Influence ◽  
Hiv Positive ◽  
Fertility Desire ◽  
Binary Logistic Regression Model ◽  
Reproductive Age Women ◽  
Hiv Positive Women

Abstract Background: Antiretroviral therapy scales up globally and in Ethiopia, as a result, AIDS-related mortality has reduced, but the number of new HIV infections increasing. Antiretroviral therapy in Ethiopia gives a chance of living longer for reproductive-age women. Prevention of pregnancy among HIV positive women is the second WHO prongs of HIV transmission with respecting women’s reproductive rights. Antiretroviral therapy uses improve the health of HIV positive women using and women's fertility desire increasing. Therefore this study aimed to assess the fertility desire and associated factors among ART user reproductive-age women. Methods: A facility-based cross-sectional study design conducted from November 2-30/2018. The calculated sample size was 400 and study participants were selected by using systematic random sampling. A pre-tested structured questionnaire was used to collect data. A binary logistic regression model was employed and adjusted odds ratio with a 95% confidence interval used to consider statistically significant Results: A total of 397 clients were participated in the study, giving a response rate of 99.3%. The proportion of fertility desire in this study was 55.2 %(95% CI, 50.4%- 60.2%). A duration of marriage < 4 year [AOR=6.9(95 CI: 1.65, 28.81)], and 5–9 years duration of marriage [AOR= 13.8 (95% CI: 2.39, 80.39)] higher as compared to 15 years and above, family influence 3.4 times more likely to have fertility desire than have no family influence [AOR= 3.4 (95% CI: 1.06, 11.25)], partner desire 4.3 times more likely have had fertility desires as compared to with counterpart [AOR= 4.3 (95% CI: 1.93,9.41)], and discussion with health care provider 66 % less likely to have fertility desire as compared with counterpart [AOR = 0.34 (95% CI: 0.39, 3.31)]. Conclusion: In this study, we have identified a high proportion of fertility desire among ART user reproductive-age women. The duration of marital status, partner influence, family influence, and discussion of health care were associated with fertility desire. Family-oriented counseling, partner involvement on reproductive health services should be encouraged to support the rights of all women to safely achieve their fertility. Keywords: Fertility desire, reproductive age, women on ART.

scholarly journals Describing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Rachel Musomba ◽  
Frank Mubiru ◽  
Shadia Nakalema ◽  
Hope Mackline ◽  
Ivan Kalule ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Older Women ◽  
First Trimester ◽  
Hiv Positive ◽  
Urban Centre ◽  
Factors Associated ◽  
Point Of Entry ◽  
Art Initiation ◽  
Hiv Positive Women

Introduction. We aim to describe the time of entry into care and factors associated with being lost to program (LTP) in pregnant women on Option B Plus in an integrated HIV and antenatal care (ANC) clinic in Uganda. Methods. We included all pregnant women enrolled into the integrated HIV-ANC clinic from January 2012 to 31st July 2014, while the follow up period extended up to October 30th 2015. LTP was defined as being out of care for ≥3 months. Results. Overall 856 women were included. Only 36.4% (86/236) of the women were enrolled in the first trimester. Overall 69 (8.1%) were LTP. In the multivariate analysis older women (HR: 0.80 per five-year increase, CI: 0.64–1.0, and P=0.060) and women on ART at the time of pregnancy (0.58, CI: 0.34–0.98, and P=0.040) were more likely not to be LTP. Among women already on ART at the time of pregnancy no factor was associated with LTP. Conclusion. Our results suggest the need for interventions to enhance prompt linkage of HIV positive women to HIV services for ART initiation and for increased retention particularly in young and ART naive women.

scholarly journals THE THE IMPACT OF ANTIRETROVIRAL THERAPY ON HEMOGLOBIN LEVELS OF HIV/AIDS PATIENTS AT MERPATI CLINIC, WANGAYA HOSPITAL, DENPASAR, BALI, INDONESIA

2020 ◽  
pp. 13-16
Author(s):  
PUTU DEWINTA DARMADA ◽  
KETUT SURYANA
Keyword(s):  
Antiretroviral Therapy ◽  
Total Sample ◽  
Hemoglobin Level ◽  
P Value ◽  
Aids Patients ◽  
Chi Square ◽  
Art Initiation ◽  
Chi Square Analysis ◽  
The Impact ◽  
Hiv Aids

Objective: Anemia is responsible for poor outcomes in HIV/AIDS patients. It’s related to disease progression, morbidity, and mortality. Antiretroviral therapy (ART) agent, zidovudine (ZDV) is also known to trigger anemia in the early initiation. However, studies found improved hemoglobin (Hb) levels of HIV/AIDS patients several months after ART routinely taken. This study aims to find the impact and correlation of ART on the hemoglobin level of HIV/AIDS patients. Methods: A retrospective cohort study was done at Merpati Clinic, Wangaya Hospital, Denpasar-Bali, Indonesia. Data were collected from medical records and laboratory results. A total sample of 64 HIV/AIDS patients with at least 6 mo on ART was included in this study. Results: Anemia was found in 34 (53.1%) of patients before ART initiation. After taking ART for 6 mo, we observed a significant improvement in patients’ hemoglobin levels, 48 (75%) shows increased hemoglobin levels. The paired t-test revealed a correlation between ART and Hb level (p<0.001). Fourteen (43.8%) patient taking ZDV shows no improvement, even declining of Hb level. Chi-square analysis performed with p = 0.001 to ZDV and lower or no improvement of hemoglobin level. Both results considered statistically significant (p-value less than 0.05) with a confidence interval (CI) of 95%. Relative risk (RR) of no improvement or decline in Hb level is 7 folds higher in the ZDV group than the non-ZDV group. Conclusion: This study concludes that ART affects hemoglobin levels in HIV/AIDS patients. Zidovudine regimen is more prone to lower or no increase of Hb.

scholarly journals Rapid Antiretroviral Therapy (ART) Initiation at a Community-Based Clinic in Jackson, MS

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Courtney E. Sims Gomillia ◽  
Kandis V. Backus ◽  
James B. Brock ◽  
Sandra C. Melvin ◽  
Jason J. Parham ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Median Time ◽  
Viral Suppression ◽  
Hiv Care ◽  
Virologic Suppression ◽  
Community Based ◽  
Art Initiation ◽  
Healthcare Center ◽  
The Impact

Abstract Background Rapid antiretroviral therapy (ART), ideally initiated within twenty-four hours of diagnosis, may be crucial in efforts to increase virologic suppression and reduce HIV transmission. Recent studies, including demonstration projects in large metropolitan areas such as Atlanta, Georgia; New Orleans, Louisiana; San Francisco, California; and Washington D.C., have demonstrated that rapid ART initiation is a novel tool for expediting viral suppression in clinical settings. Here we present an evaluation of the impact of a rapid ART initiation program in a community-based clinic in Jackson, MS. Methods We conducted a retrospective chart review of patients who were diagnosed with HIV at Open Arms Healthcare Center or were linked to the clinic for HIV care by the Mississippi State Department of Health Disease Intervention Specialists from January 1, 2016 to December 31, 2018. Initial viral load, CD4+ T cell count, issuance of an electronic prescription (e-script), subsequent viral loads until suppressed and patient demographics were collected for each individual seen in clinic during the review period. Viral suppression was defined as a viral load less than 200 copies/mL. Rapid ART initiation was defined as receiving an e-script for antiretrovirals within seven days of diagnosis. Results Between January 1, 2016 and December 31, 2018, 70 individuals were diagnosed with HIV and presented to Open Arms Healthcare Center, of which 63 (90%) completed an initial HIV counseling visit. Twenty-seven percent of patients were provided with an e-script for ART within 7 days of diagnosis. The median time to linkage to care for this sample was 12 days and 5.5 days for rapid ART starters (p < 0.001). Median time from diagnosis to viral suppression was 55 days for rapid ART starters (p = 0.03), a 22 day decrease from standard time to viral suppression. Conclusion Our results provide a similar level of evidence that rapid ART initiation is effective in decreasing time to viral suppression. Evidence from this evaluation supports the use of rapid ART initiation after an initial HIV diagnosis, including same-day treatment.

scholarly journals Mass Media Exposure and Timing of Antenatal Care Initiation among Women in Uganda

2021 ◽  
Author(s):  
Quraish Sserwanja ◽  
Linet M. Mutisya ◽  
Milton W. Musaba
Keyword(s):  
Mass Media ◽  
Antenatal Care ◽  
Media Exposure ◽  
First Trimester ◽  
Early Initiation ◽  
Reproductive Age ◽  
Inverse Association ◽  
Significant Positive Association ◽  
Mass Media Exposure ◽  
The Impact

Abstract Background : Early initiation of quality antenatal (ANC) in the first trimester and received quality care are highly emphasized by WHO in the new 2016 guidelines. Mass media have the potential to promote early initiation of ANC because they have been used successfully in several programmes. However, there is a paucity of literature on the impact of media exposure on the timing of ANC initiation in Uganda. Hence our study aimed at exploring associations between the different mass media exposure and timing of antenatal care initiation among women in Uganda.Methods : A cross sectional study was conducted using the Uganda Demographic and Health Survey (UDHS) 2016 weighted data of 10,152 women of reproductive age (15–49 years). Multistage stratified sampling was used to select study participants. Multivariable logistic regression was used to determine the association between mass media exposure and early initiation of antenatal care. All our analyses were done using SPSS version 25.Results : Almost a third of the women (2953/10,152, 29.1%, 95% CI: 27.9-29.6) initiated their first ANC contact in the first trimester. In the final multivariable analyses, exposure to television (TV) and radio, belonging to the Northern and Western regions, younger age and less household size each had a significant positive association with earlier ANC initiation while lower education attainment had an inverse association. Women who were exposed to TV (adjusted OR (AOR 1.19, 95% CI 1.03 to 1.38) and radio (AOR 1.14, 95% CI 1.01 to 1.29) were 19% and 14% more likely to initiate ANC earlier compared to those who were not exposed to TV and radio respectively.Conclusion : In Uganda, less than a third of women initiated ANC in the first trimester. Young women from a smaller household with access to either a radio or television, and residing in Northern and Western regions were more likely to initiate ANC early enough. In order to promote early initiation of ANC, the government needs to intensify mass media campaigns on local media houses that promote this practice.

scholarly journals Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

2020 ◽  
Author(s):  
Zhihua Wan ◽  
Huan Zhang ◽  
Haigang Xu ◽  
Yang Hu ◽  
Cai Tan ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Jiangxi Province ◽  
Adequate Treatment ◽  
Maternal Treatment ◽  
Syphilis Treatment ◽  
Maternal Syphilis ◽  
The Impact

Abstract Background Studies investigating the associations of maternal syphilis treatment during pregnancy with pregnancy outcomes mainly concentrated in economically developed areas. Limited data are available in economically underdeveloped areas, such as Jiangxi Province. The study aims to investigate the impact of maternal treatment during pregnancy on pregnancy outcomes in Jiangxi Province, China. Methods Data were obtained from the China’s Information System of Prevention of Mother-to-Child Transmission (PMTCT) of syphilis management in Jiangxi Province. All syphilis infected pregnant women who delivered at gestational age of 28 weeks or more and were registered in this system between 1 January 2013 and 31 December 2019 were enrolled. Pregnancy outcomes were evaluated by group-specific analyses according to their treatment status, adequacy and initiation time. Results 4210 pregnant women with syphilis infection were included in the analyses. Infants born to untreated mothers were at significantly higher risk for stillbirth (adjusted odds ratio (aOR) = 1.74, 95% CI, 1.01-3.00, P = 0.045), preterm birth (aOR = 1.27, 95% CI, 1.02–1.59, P = 0.034) and low birth weight (LBW) (aOR = 1.44; 95% CI, 1.11–1.86, P = 0.006) than those born to treated mothers after adjustment for confounding factors. Moreover, a significantly higher risk of stillbirth (aOR = 3.68; 95% CI, 1.62–8.34, P = 0.002), preterm birth (aOR = 2.26; 95% CI, 1.71-3.00, P < 0.001), LBW (aOR = 2.23; 95% CI, 1.59–3.14, P < 0.001) and congenital syphilis (CS) (aOR = 3.63; 95% CI, 1.80–7.31, P < 0.001) was found in infants exposed to mothers treated inadequately than those treated adequately. In addition, no pregnant women who initiated the treatment in the first trimester delivered a neonatal CS case. Compared with mothers who initiated treatment in the first trimester, those initiated in the third trimester suffered an increased risk of stillbirth (aOR = 4.48; 95% CI, 1.31–15.30, P = 0.017), preterm birth (aOR = 2.34; 95% CI, 1.61–3.40, P < 0.001) and LBW (aOR = 3.25; 95% CI, 1.97–5.37, P < 0.001). Conclusions Maternal treatment, especially early and adequate treatment, plays a crucial role in mitigating adverse pregnancy outcomes among syphilis infected women.

scholarly journals The impact of high maternal body mass index on obstetric and perinatal outcomes

2021 ◽  
Vol 10 (3) ◽  
pp. 1031
Author(s):  
Natasha Sharma ◽  
Manasi Patnaik
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Pregnancy Outcomes ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Adverse Pregnancy ◽  
The Impact

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period. 

scholarly journals Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

2020 ◽  
Author(s):  
Zhihua Wan ◽  
Huan Zhang ◽  
Haigang Xu ◽  
Yang Hu ◽  
Cai Tan ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Jiangxi Province ◽  
Adequate Treatment ◽  
Syphilis Treatment ◽  
Maternal Syphilis ◽  
The Impact

Abstract BackgroundStudies investigating the associations of maternal syphilis treatment with birth outcomes mainly concentrated in economically developed areas. Limited data are available in economically underdeveloped areas, such as Jiangxi Province. The study aims to investigate the impact of maternal treatment on birth outcomes in Jiangxi Province, China.MethodsData were obtained from the China’s Information System of Prevention of Mother-to-Child Transmission in Jiangxi Province. All syphilis infected pregnant women who delivered ≥28 gestational weeks and were registered in this system between 1 January 2013 and 31 December 2019 were enrolled. Pregnancy outcomes were evaluated by group-specific analyses according to their treatment status, adequacy and initiation time.Results4210 syphilis infected pregnant women were included in the analyses. Infants born to untreated mothers (n = 1364) were at significantly higher risk for stillbirth (adjusted odds ratio (aOR) = 1.74, 95% CI, 1.01-3.00, P = 0.045), preterm birth (aOR = 1.27, 95% CI, 1.02-1.59, P = 0.034) and low birth weight (LBW) (aOR = 1.44; 95% CI, 1.11-1.86, P = 0.006) than those born to treated mothers (n = 2846) after adjustment for confounding factors. A significantly higher risk of stillbirth (aOR = 3.68; 95% CI, 1.62-8.34, P = 0.002), preterm birth (aOR = 2.26; 95% CI, 1.71-3.00, P < 0.001), LBW (aOR = 2.23; 95% CI, 1.59-3.14, P < 0.001) and congenital syphilis (CS) (aOR = 3.63; 95% CI, 1.80-7.31, P < 0.001) was found in infants exposed to mothers treated inadequately (n = 1299) than those treated adequately (n = 1547). No pregnant women who initiated the treatment in the first trimester (n = 682) delivered a neonatal CS case. Compared with mothers who initiated treatment in the first trimester (n = 682), those initiated in the third trimester (n = 1234) suffered an increased risk of stillbirth (aOR = 4.48; 95% CI, 1.31-15.30, P = 0.017), preterm birth (aOR = 2.34; 95% CI, 1.61-3.40, P < 0.001) and LBW (aOR = 3.25; 95% CI, 1.97-5.37, P < 0.001). ConclusionsMaternal treatment, especially early and adequate treatment, plays a crucial role in mitigating adverse pregnancy outcomes among syphilis infected women.

scholarly journals Safety and Effectiveness of Isoniazid Preventive Therapy in Pregnant Women Living with Human Immunodeficiency Virus on Antiretroviral Therapy: An Observational Study Using Linked Population Data

2020 ◽  
Vol 71 (8) ◽  
pp. e351-e358 ◽  
Author(s):  
Emma Kalk ◽  
Alexa Heekes ◽  
Ushma Mehta ◽  
Renee de Waal ◽  
Nisha Jacob ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Absolute Risk ◽  
First Trimester ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Isoniazid Preventive Therapy ◽  
Immunodeficiency Virus

Abstract Background Isoniazid preventive therapy (IPT) is widely used to protect against tuberculosis (TB) in people living with human immunodeficiency virus (HIV). Data on the safety and efficacy of IPT in pregnant women living with HIV (PWLHIV) are mixed. We used an individual-level, population-wide health database to examine associations between antenatal IPT exposure and adverse pregnancy outcomes, maternal TB, all-cause mortality, and liver injury during pregnancy through 12 months postpartum. Methods We used linked routine electronic health data generated in the public sector of the Western Cape, South Africa, to define a cohort of PWLHIV on antiretroviral therapy. Pregnancy outcomes were assessed using logistic regression; for maternal outcomes we applied a proportional hazards model with time-updated IPT exposure. Results Of 43 971 PWLHIV, 16.6% received IPT. Women who received IPT were less likely to experience poor pregnancy outcomes (adjusted odds ratio [aOR], 0.83 [95% confidence interval {CI}, .78–.87]); this association strengthened with IPT started after the first trimester compared with none (aOR, 0.71 [95% CI, .65–.79]) or with first-trimester exposure (aOR, 0.64 [95% CI, .55–.75]). IPT reduced the risk of TB by approximately 30% (aHR, 0.71 [95% CI, .63–.81]; absolute risk difference, 1518/100 000 women). The effect was modified by CD4 cell count with protection conferred if CD4 count was ≤350 cells/μL (aHR, 0.51 [95% CI, .41–.63]) vs 0.93 [95% CI, .76–1.13] for CD4 count &gt;350 cells/µL). Conclusions This analysis of programmatic data is reassuring regarding the safety of antenatal IPT, with the greatest benefits against TB disease observed in women with CD4 count ≤350 cells/μL.

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