Human Immunodeficiency Virus and Pregnancy: A retrospective descriptive cross-sectional study of prevalence, maternal, obstetrical and neonatal outcome, at a tertiary care hospital in the Sultanate of Oman

Objective: To investigate the prevalence of human immunodeficiency virus (HIV) in pregnant women, and the maternal, obstetrical and neonatal outcome over a thirteen year period (2005-2017) at the Sultan Qaboos University hospital, a tertiary hospital in Muscat, Oman. Methods: Our study design was a retrospective descriptive cross sectional study of HIV positive women in the department of obstetrics and gynaecology. We had an unlimited sample size due to the rarity of the disease and aimed to include all pregnant Omani women who tested positive for HIV in their antenatal screening (ANS) during the period 1 st of January 2005 to 31 st December 2017 with the exclusion of non-Omanis. Ethical approval was obtained from hospital ethics committee and patient records were reviewed using the hospital information system (HIS) service. Results: There were a total of 13,688 women with 104,281 pregnancies over the study period. The prevalence of Omani pregnant women with HIV was 0.1% (1:1000) with 0.03% of seropositive pregnancies (3:10,000). Of these seropositive pregnancies, 78.6% were known HIV carriers, whilst 21.4% were newly diagnosed cases. The live birth rate was 90.3% with 9.7% ending up in miscarriage. All the miscarriages were to known HIV positive mothers who were managed in accordance to international guidelines. Of the livebirths, 10.7% were unknown HIV positive mothers with a mean gestational age of 39.67 weeks and a mean birth weight of 3.21kg. The rate of mother to child transmission (MTCT) of HIV in this group was 33.3%. In contrast, 89.3% of the livebirths to known HIV positive mothers had delivered neonates with a mean gestational age was 37.48 weeks and a mean birth weight of 2.63kg with 0% MTCT. Modes of delivery, antepartum, intrapartum and postpartum complications as well as long-term neonatal outcomes were analysed according to the status of the mother at first presentation. Conclusion: Strategies have been placed by programmes in the Sultanate to focus on pregnant women wellbeing and protection of newborns against HIV infection. Strict implementations on preventing mother to child transmission (MTCT) allowed preventing HIV in children possible. Antiretroviral therapy (ART) significantly reduces vertical transmission of HIV, in addition to abstinence of breastfeeding. More importantly, all HIV-positive pregnant women should follow the prevention of MTCT programs set out by the ministry of health.