Abstract
Our study compares perinatal outcomes among HIV+ versus HIV− advanced maternal aged (AMA) women. A retrospective cohort study of AMA deliveries from 2000 to 2009 was performed. HIV+ (group A) women were compared to temporally matched HIV− (group B) women. Demographics, medical comorbidities, HIV treatment, and delivery data were collected. SAS was used for data analysis with p<0.05 considered significant. Seventy-one patients per study group were reviewed; for group A, the mean CD4 count near delivery was 507±363; 75% (34/45) had viral load ≤400 in the third trimester and 58% were on a protease inhibitor regimen. HIV+ women had significantly higher preterm delivery (PTD) <37 weeks (A: 40.85%, B: 16.90%, p=0.0016). Logistic regression performed revealed that the odds of PTD was 2.83 (CI 1.22–6.54) for HIV+ and 4.02 (CI 1.27–12.72) for drug use independent of other factors. The pathophysiology of PTD among HIV+ AMA women warrants prospective examination to better define the causal relationship.
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