Factors associated with delivering premature and/or low birth weight infants among pregnant HIV-positive women on antiretroviral treatment at Dr George Mukhari Hospital, South Africa

Background: Prematurity and low birthweight (LBW) deliveries amongst pregnant women infected with the human immunodeficiency virus (HIV) remain a challenge worldwide. The association between prematurity, LBW and antiretroviral therapy (ART) or prophylactic antiretroviral drug (ARV) exposure in pregnancy is unclear. This study evaluates the risk of delivering a premature and/or LBW infant among HIV-positive pregnant women on ART or prophylactic ARV.Methods: A cross-sectional study was conducted (April to October 2012). HIV-positive women on prophylactic ARV (dual therapy) or lifelong ART (triple therapy or HAART) were enrolled in the study. Women who did not have a documented HIV result during pregnancy, those tested before delivery and those found to be HIV-positive were considered as not exposed to ARV drugs during pregnancy. This group received a standard dose of nevirapine during labour. The control group was made up of HIV-negative women.Results: Of the 496 mothers enrolled in the study, 59% (288/496) were HIV-positive, of whom 72% (206/288) were on ART or prophylactic ARV. The mean age was 27.6 ± 6.5 years (15 to 47 years). The mean gestational age (GA) was 35.9 ± 3.6 weeks (24– 42 weeks). Infants’ birthweights ranged from 550 to 4 900 g (2.5 ± 0.9 kg). HIV-positive mothers not on ART or ARV prophylaxis were likely to deliver an infant at GA 28 weeks (p 0.05) or birthweight 1 000 g (p 0.05) compared with their counterparts. Conclusion: HIV-positive pregnant women not on ART or ARV prophylaxis were at a risk of delivering babies at GA 28 weeks or birthweight 1 000 g. There is a need to encourage early and regular attendance for antenatal care so that HIV-positive pregnant women can be identified and have access to treatment during pregnancy.

Download Full-text

Perencanaan Memiliki Anak pada Wanita dengan HIV Positif di Kota Semarang

JURNAL PROMOSI KESEHATAN INDONESIA ◽

10.14710/jpki.14.2.108-121 ◽

2019 ◽

Vol 14 (2) ◽

pp. 108

Author(s):

Nastiti Bandari Pratiwi ◽

Zahroh Shaluhiyah ◽

Antono Suryoputro

Keyword(s):

Pregnant Women ◽

Quantitative Research ◽

Qualitative Data ◽

Hiv Treatment ◽

Hiv Positive ◽

Cross Sectional ◽

Cd4 Cell Count ◽

Hiv Positive Women ◽

Women With Hiv ◽

Fertile Women

Background: Pregnant women with HIV positive is potential risk to transmit the virus to their infants. Prevention Mother to Child Transmittion (PMTCT) program is a solution for HIV women if they want to have children. However, most pregnant women detected HIV positive when they have been pregnant for more than 6 months through Provider initiated test and counselling (PITC). On the other hand, the data shows that the increasing number of HIV positive women who have been willing to have children. This research aims to identify and examine the factors influence the plan of having children among HIV-positive women who access HIV treatment in Kariadi Hospital Semarang. Method: This study employs a quantitative research design with cross sectional approach, followed by qualitative study to explore the feeling and attitudes of women with HIV positive to plan of having children. There were 31 women involved in this study, selected with the criteria of fertile women HIV positive who have been taking antiretroviral therapy in Kariadi Hospital and willing to participate in this study. Qualitative data collected from two women who has been planning to have children. Quantitative data were analyzed by univariate, Chi-Square and multiple logistic regression. Whilst, qualitative data employ content analysis.Results: There were 16% of women with HIV positive who have been intending to have children in this study. The rest have not planned it because they worried if their pregnancy and delivery could transmit HIV to their infants. CD4 cell count, ARV access and women’s attitudes have significant correlation to the intention of having children among women with HIV positive. Comprehensive information about PMTCT and ARV were needed to deliver to fertile women with HIV positive.

Download Full-text

Reproductive Intentions of HIV-Positive Women on ARV Treatment in Abia State, Southeast Nigeria

ISRN Public Health ◽

10.1155/2014/593067 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Ijeoma Nduka ◽

Ezinna Ezinne Enwereji ◽

Enyinnaya C. Nduka ◽

Reginald Ahuizi Eke

Keyword(s):

Family Counseling ◽

University Teaching ◽

Systematic Sampling ◽

Hiv Positive ◽

African Culture ◽

Cross Sectional ◽

Hiv Positive Women ◽

Reproductive Intentions ◽

The Mean ◽

Living Children

Introduction. In the African culture, the primary reason for marriage is procreation. Every female strives to perform this role irrespective of her health status so as to fulfill part of the conditions for maintaining the marriage. The question is, to what extent are HIV-positive women aware of the risks of fulfilling this role? The study aimed to determine the reproductive intentions of HIV-positive women in Abia State. Materials and Methods. This was a longitudinal cross-sectional descriptive study conducted among married HIV-positive women attending the Heart to Heart treatment centre in Abia State University Teaching Hospital from February to October 2013. Systematic sampling was used to select 250 married women between the ages of 15–49 years who are on antiretroviral therapy. Interviewer administered questionnaire and focus group discussion were used to obtain relevant information from the participants. Data were analysed qualitatively and quantitatively. SPSS version 17 software was also used in the analyses. Results. The mean number of living children of the respondents was 2.3 ± 4.7. A good proportion of the respondents, 158 (63.7%) the desired to have more children. The younger the age group of the respondents (OR = 7.33), the lower their parity (OR = 3.69) and more regular they attended ARV clinic (OR = 47.76) the more they desired to have more children. The main reason for desiring more children was the quest to have male children. In the words of one respondent, “without a male child, the marriage is not secure. The woman can be chased out at any time.” Conclusion. The fact that a large proportion of HIV-positive women, irrespective of the mean number of living children and their gender, still desired to have more children shows poor knowledge of the risk they are exposed to by having large number of children. Family counseling/education on the benefits of using family planning devices especially condom is necessary for HIV-positive women and their male partners.

Download Full-text

Nutritional Status of HIV-Positive Pregnant Women in Luanda, Angola

10.21203/rs.3.rs-46788/v1 ◽

2020 ◽

Author(s):

Marli Stela Santana ◽

Maura Eunice João FILIPE

Keyword(s):

Nutritional Status ◽

Pregnant Women ◽

Nutritional Assessment ◽

Subjective Evaluation ◽

Descriptive Study ◽

Hiv Positive ◽

Cross Sectional ◽

Healthy Pregnancy ◽

Hiv Positive Women ◽

Current Weight

Abstract During pregnancy, maternal intake of nutrients and their nutritional status affects both mother and baby. Good nutritional status plays an important role for a healthy pregnancy, for this it is necessary that the pregnant woman have a healthy diet to assist in weight gain.Objective: To evaluate the pregestational and gestational nutritional status of HIV-positive women.Methods: This is a cross-sectional and descriptive study, conducted from August to November 2018 in which 171 HIV-positive pregnant women were selected at random, in order of arrival and submitted to nutritional assessment through the Global Subjective Evaluation, whose data collected, were analyzed using EpiInfo software version 7.2.Results: From the main results found it was observed the presence of maternal nutritional eutrophic, considering the pre-gestational Body Mass Index (BMI) of 107 (62.56%), and the gestational BMI of 94 (54.97%). It was found 31(18.12%) of pre-gestational overweight and 54 (28.07%) of overweight during pregnancy, and it was also observed that 12 (7%) of pregnant women were obese before pregnancy and 15 (15.28%) became obese during pregnancy. A significant association was found between pregestational BMI, height (p˂0.0001), gestational BMI, current weight (p˂0.0003), brachial perimeter (p˂0.002), and uterine height (p˂0.005).Conclusion: The results of this study indicate the need to develop nutritional care programs for HIV-positive women, in order to ensure an adequacy of their nutritional status.

Download Full-text

Association Between Anaemia And Low Birth Weight Among HIV -Infected Pregnant Women Aged 15 – 49 Years In Zimbabwe : A Cross-Sectional Study

10.21203/rs.2.24714/v1 ◽

2020 ◽

Author(s):

Dorothy T Chisare ◽

Simbarashe Takuva ◽

Tariro J. Basera ◽

Natasha Khamisa ◽

Jacqueline Witthuhn

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Secondary Data ◽

Hiv Positive ◽

Cross Sectional ◽

Maternal Anaemia ◽

Hiv Positive Women ◽

Increased Risk ◽

The Relationship

Abstract Background In Zimbabwe, almost 25% of infants are born with low birth weight (LBW). LBW accounts for over half of the neonatal deaths in the country. Anaemia during pregnancy has been inconsistently associated with an increased risk of LBW. However, very little data is available from countries where HIV prevalence is high, wherein HIV is also known to be a common risk factor to LBW. This study examined the relationship between maternal anaemia and LBW among HIV-infected pregnant women in Zimbabwe. Methods This was a secondary data analysis of the 2015 Zimbabwe Demography and Health Survey. Data for 809 HIV positive women aged 15-49 years and their infants from all live births preceding the survey by 5 years were included in the study. Modified-Poisson regression methods were used to determine the association between anaemia and LBW while adjusting for other risk factors. Results The prevalence of maternal anaemia and LBW among the HIV-infected pregnant women was 42.3% (n=342) and 16.3% (n =132) respectively. The prevalence of LBW was14.6% (n=50) and 17.6% (n=82) among anaemic and non-anaemic HIV positive women respectively (p=0.264). HIV infected pregnant women with anaemia had a 25% less chance of giving birth to infants with LBW compared to HIV infected mothers without anaemia, however, the association was not statistically significant (RR 0.75; 95% CI 0.53- 1.05). Conclusions The findings demonstrate a high prevalence of anaemia and LBW among HIV infected pregnant women. Nonetheless, maternal anaemia was not associated with LBW. There is a need for adapted monitoring of HIV-positive pregnant women and affordable improved nutrition during antenatal care to reduce the risk of LBW infants and maternal anaemia levels. Further research examining the relationship between maternal anaemia and LBW among HIV positive pregnant women whilst factoring in the role of ART and the severity of anaemia is required.

Download Full-text

Cytokines Level (Il8 and Il17) in Pregnant Women with Toxoplasmosis in Khartoum State

Journal of Parasite Research ◽

10.14302/issn.2690-6759.jpar-19-2971 ◽

2019 ◽

Vol 1 (1) ◽

pp. 8-12

Author(s):

Wahaj M. M ◽

Satti, A. B ◽

Abdalla H.S ◽

Ahmed S. Kabbashi

Keyword(s):

Toxoplasma Gondii ◽

Serum Level ◽

Pregnant Women ◽

Venous Blood ◽

Control Group ◽

Cross Sectional ◽

Study Population ◽

Patient’S Information ◽

The Mean ◽

Toxoplasma Gondii Infection

Toxoplasmosis is one of the most important zoonotic diseases worldwide caused by Toxoplasma gondii that leads to abortion or hydrocephalus during pregnancy. It’s a comparative cross-sectional one designed to assess immunoglobulins and cytokines in pregnant women. A total of 300 venous blood samples were collected from each pregnant woman and centrifuged to obtain serum. Patient’s information was recorded in a questionnaire previously designed for the purpose of analysis. In addition, 40 uninfected women were enrolled in the study as control group to assess the level of IL8 and IL17 cytokines. The overall seropositive rate of Toxoplasma gondii infection was 22.6%. Within the positive cases of study population, only 16 and 13 showed positive results of IL8, IL17 respectively. The results showed highly significant increase in the mean serum level of IL8 (210.25pg/ml) and IL17 (203.15 pg/ml) when compared to the control group who showed 68.9 pg/ml and 54.8 pg/ml respectively. The serum level of proinflammatory cytokines investigated in this study seems to be increased in patients with serological evidence of Toxoplasma gondii infection. Our study concludes that IL-17 and IL-8 involved in the induction of inflammation and toxoplasmosis disease.

Download Full-text

Pregnant and Postpartum Women’s Experiences and Perspectives on the Acceptability and Feasibility of Copackaged Medicine for Antenatal Care and PMTCT in Lesotho

AIDS Research and Treatment ◽

10.1155/2015/435868 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10

Author(s):

Michelle M. Gill ◽

Heather J. Hoffman ◽

Appolinaire Tiam ◽

Florence M. Mohai ◽

Majoalane Mokone ◽

...

Keyword(s):

Drug Delivery ◽

Antenatal Care ◽

Pregnant Women ◽

Cross Sectional Study ◽

Hiv Positive ◽

Structured Interviews ◽

Cross Sectional ◽

Hiv Positive Women ◽

Related Service ◽

Improved Design

Objective.To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women.Methods.Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013.Results.290 HIV-negative women and 437 HIV-positive women (n=727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were suggested. Positive experiences included that the pack helped women take pills as instructed and contents promoted healthy pregnancies. Negative experiences included inadvertent pregnancy disclosure and discomfort carrying the pack in communities. Implementation was also feasible; 85.2% of SI participants reported adequate counseling time, though 37.8% felt pack use caused clinic delays. SSI participants reported improvement in service quality following pack introduction, due to more comprehensive counseling.Conclusions.A prepackaged drug delivery mechanism for ANC/PMTCT medicines was acceptable and feasible. Findings support continued use of this approach in Lesotho with improved design modifications to reflect the current PMTCT program of lifelong treatment for all HIV-positive pregnant women.

Download Full-text

Study of serum FT3, FT4 and TSH in pregnant women

Journal of Dhaka Medical College ◽

10.3329/jdmc.v23i1.22697 ◽

2015 ◽

Vol 23 (1) ◽

pp. 68-72

Author(s):

Shahanara Yeasmin ◽

AFM Anwar Hossain ◽

Tahmina Yeasmin ◽

Md Ruhul Amin ◽

Qazi Shamima Akhter ◽

...

Keyword(s):

Pregnant Women ◽

Control Group ◽

Childbearing Age ◽

Cross Sectional ◽

Medical College ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B ◽

Tsh Levels

Background: Thyroid diseases have a strong predominance in woman of childbearing age. Pregnancy may be associated with thyroid dysfunction. The aim of the present study was to assess the serum FT3, FT4 and TSH levels in pregnant women. Methods: This cross-sectional analytical study was done in the Department of Physiology of Dhaka Medical College, Dhaka, from July 2006 to June 2007. Total 50 apparently healthy women of low socioeconomic class, age ranged from 18-40 years were selected from the Outpatient Department of Urban Primary Health Care Project (UPHCP) at Mirpur, Dhaka. Out of them 30 pregnant women of different trimester were taken as study group (group A) and 20 age matched non pregnant women were taken as control (group B). Serum FT3, FT4 and TSH levels were parameters in both groups. Statistical analysis was done by the SPSS version 12.0. Results: The mean serum FT3 levels were 6.36±1.16 pmol/L and 6.381.36 pmol/L in group A (Study) and group B (control) respectively. The mean serum FT4 levels were 20.25±4.77 pmol/L and 19.39±8.17 pmol/L in group A (Study) and group B (control) respectively. The mean serum TSH levels were 0.96±0.96 mIu/L and 1.27±0.86 mIu/L in group A (Study) and group B (control) respectively. The difference was not significant (p>0.05) between group A and B. Conclusion: From the results obtained in the present study, it may be concluded that there is no change of serum FT3, FT4 and TSH level in pregnancy. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22697 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 68-72

Download Full-text

Prevalence and determinants of anemia amongst HIV positive pregnant women in a tertiary Hospital in Nigeria

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205216 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4825

Author(s):

Innocent O. Eze ◽

Clara U. Innoeze ◽

Malachy E. Ayogu ◽

Stephen C. Eze

Keyword(s):

Pregnant Women ◽

Cd4 Count ◽

Hiv Positive ◽

Hiv Status ◽

Cross Sectional ◽

Positive Group ◽

Increased Risk ◽

The Mean ◽

Prevalence Of Anemia ◽

Hiv Negative

Background: In pregnancy, anemia is associated with increased risk of both maternal and fetal morbidity and mortality especially in HIV situation. To determine the prevalence and determinants of anemia in HIV positive compared to HIV negative women.Methods: This was a cross sectional study carried out from June 2016 to December 2017 amongst pregnant women who presented to the antenatal clinic. Information on socio-demographic variables and laboratory test to determine the hemoglobin levels and CD4 count (for the HIV positive women) were carried out. A total of 350 subjects with equal number of HIV positive and HIV negative pregnant women were recruited. Variables were compared between the two groups using software package for social sciences version 20. P values<0.05 at 95% confidence interval are considered statistically significant.Results: The mean age for HIV positive and negative were 31.54 ±4.1 and 29.03 respectively while, mean gestational age at booking for HIV positive and negative were 20.41±8.61 and 22.37±7.4 weeks respectively. The HIV positive group had a mean parity of 2.02±1.5, and 2.56±1.2 was that of the HIV negative group. The mean hemoglobin statuses at booking were 9.92±1.8 g/dl and 10.6±1.1 g/df HIV positive and HIV negative women respectively. The mean CD4+ at booking for HIV positive group was 478±251 per microliter. The overall prevalence of anemia irrespective of HIV status was 36.6%. The prevalence of anemia in HIV positive and negative women were 44.6% and 28.6% respectively. There was statistically significant relationship between anemia and HIV status (p=0.002).Conclusions: There was inverse relationship between CD4+ count and anemia. Low CD4+ count and non-use of HAART at booking were important determinants of anemia among the HIV.

Download Full-text

Effect of Antiretroviral Drugs on Liver Biochemical Parameters of HIV/AIDS-Infected Pregnant Women in Enugu Metropolis, Nigeria: a Cross-Sectional Study

Current Women s Health Reviews ◽

10.2174/1573404816999200922145334 ◽

2020 ◽

Vol 16 ◽

Author(s):

Gordon I. E. Udalor ◽

Chukwugozie N. Okwuosa ◽

Ikenna K. Uchendu ◽

Chidozie E. Agu

Keyword(s):

Pregnant Women ◽

Liver Damage ◽

Biochemical Parameters ◽

Antiretroviral Drugs ◽

Chronic Liver ◽

Hiv Positive ◽

Chronic Liver Damage ◽

Cross Sectional ◽

Hiv Positive Women ◽

Increased Risk

Background and Objective: Certain liver diseases are uniquely associated with pregnancy, whereas others are unrelated. Highly Active Antiretroviral Therapy (HAART)-associated hepatic toxicity is of increasing concern in the management of patients with HIV/AIDS. There is no available data on whether pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART. We evaluated the effects of antiretroviral drugs on the liver biochemical parameters in HIV-infected pregnant women. Methods: Using cross-sectional survey design, 171 women were exclusively screened for hepatitis B and hepatitis C infections; grouped as 50 HIV sero-negative pregnant women, 20 newly diagnosed HIV-infected pregnant women (treatment-naïve), 51 HIV-infected pregnant women already on HAART, 12 non-pregnant infected females (treatmentnaive) and 38 non-pregnant HIV-infected women on HAART. Liver biomarkers were determined using standard methods. Student’s t-test and one-way analysis of variance (ANOVA) followed by Tukey’s Post-HOC multiple comparison tests were used to analyse the results. Results: The Aspatate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP) and Total Bilirubin (TB) levels in HIV-infected pregnant women on HAART were elevated. The AST (29.40±4.35 U/L) of naïve HIV-infected pregnant women was significantly low (p<0.05) compared to non-pregnant naive HIV-infected women with AST (53.36±5.92 U/L). Also, the ALP (272.5±22.79 U/L) and TP (80.9±4.40 g/L) of naïve HIV-infected pregnant women were highly significant (p<0.05) compared to non-pregnant naive HIV-infected women with ALP and TP levels of (200.30±12.74 U/L) and (63.70±6.50) g/L respectively. On the basis of trimester, HIV-positive pregnant women on HAART had significantly higher levels of liver markers when compared with that of HIVsero-negative pregnant women. Interpretation and Conclusion: Pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART.

Download Full-text

PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.18 ◽

2018 ◽

Vol 8 (6) ◽

pp. 138-144

Author(s):

Thien Nguyen Duc ◽

Tai Tran Tan

Keyword(s):

Periodontal Disease ◽

Pregnant Women ◽

Oral Hygiene ◽

Disease Status ◽

Incidence Rates ◽

Gestation Period ◽

Treatment Needs ◽

Cross Sectional ◽

Mean Values ◽

The Mean

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

Download Full-text