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Buchan S, Muldoon KA, Spaans JN, Balfour L, Samson L, Walker M, Cameron DW. Increasing Number and Proportion of Adverse Obstetrical Outcomes among Women Living with HIV in the Ottawa Area: A 20-Year Clinical Case Series. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2016; 2016:1546365. [PMID: 27528877 PMCID: PMC4978822 DOI: 10.1155/2016/1546365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/28/2016] [Accepted: 05/16/2016] [Indexed: 11/18/2022]
Abstract
Background. The prevalence and associated risks with adverse obstetrical outcomes among women living with HIV are not well measured. The objective of this study was to longitudinally investigate the prevalence and correlates of adverse obstetrical outcomes among women with HIV. Methods. This 20-year (1990-2010) clinical case series assessed the prevalence of adverse obstetrical outcomes among pregnant women with HIV receiving care at The Ottawa Hospital (TOH). General estimating equation modeling was used to identify factors independently associated with adverse obstetrical outcomes, while controlling for year of childbirth clustering. Results. At TOH, there were 127 deliveries among 94 women (1990-2010): 22 preterm births, 9 births with low birth weight, 12 births small for gestational age, and 4 stillbirths. Per year, the odds of adverse obstetrical outcomes increased by 15% (OR: 1.15, 95% CI: 1.03-1.30). Psychiatric illness (AOR: 2.64, 95% CI: 1.12-6.24), teen pregnancy (AOR: 3.35, 95% CI: 1.04-1.46), and recent immigrant status (AOR: 7.24, 95% CI: 1.30-40.28) were the strongest correlates of adverse obstetrical outcomes. Conclusions. The increasing number and proportion of adverse obstetrical outcomes among pregnant women with HIV over the past 20 years highlight the need for social supports and maternal and child health interventions, especially among adolescents, new immigrants, and those with a history of mental illness.
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Affiliation(s)
- Sarah Buchan
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- Department of Medicine, Division of Infectious Disease, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
| | - Katherine A. Muldoon
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8L6
| | - Johanna N. Spaans
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
| | - Louise Balfour
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- Department of Medicine, Division of Infectious Disease, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- Department of Obstetrics and Gynaecology, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
| | - Lindy Samson
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada K1H 8L1
| | - Mark Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8L6
- Department of Obstetrics and Gynaecology, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
| | - D. William Cameron
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- Department of Medicine, Division of Infectious Disease, The Ottawa Hospital, Ottawa, ON, Canada K1H 8L6
- School of Epidemiology, Public Health and Presentation Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8L6
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