Timing of combination antiretroviral therapy (cART) initiation is not associated with stillbirth among HIV-infected pregnant women in Malawi.
Adult
Anti-Retroviral Agents
/ administration & dosage
Cohort Studies
Female
Gestational Age
HIV Infections
/ drug therapy
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical
/ prevention & control
Logistic Models
Malawi
/ epidemiology
Male
Multivariate Analysis
Obstetric Labor Complications
/ epidemiology
Pregnancy
Risk Factors
Stillbirth
/ epidemiology
Time Factors
Young Adult
HIV
VIH
Malawi
Option B+
combination antiretroviral therapy
mortinaissance
option B+
stillbirth
traitement de combinaison d'antirétroviraux
Journal
Tropical medicine & international health : TM & IH
ISSN: 1365-3156
Titre abrégé: Trop Med Int Health
Pays: England
ID NLM: 9610576
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
pubmed:
21
3
2019
medline:
4
6
2020
entrez:
21
3
2019
Statut:
ppublish
Résumé
To assess the association between timing of maternal combination ART (cART) initiation and stillbirth among HIV-infected pregnant women in Malawi's Option B+ programme. Cohort study of HIV-infected pregnant women delivering singleton live or stillborn babies at ≥28 weeks of gestation using routine data from maternity registers between 1 January 2012 and 30 June 2015. We defined stillbirth as death of a foetus at ≥28 weeks of gestation. We report proportions of stillbirth according to timing of maternal cART initiation (before pregnancy, 1st or 2nd trimester, or 3rd trimester or labour). We used logistic regression, with robust standard errors to account for clustering of women within health facilities, to investigate the association between timing of cART initiation and stillbirth. Of 10 558 mother-infant pairs abstracted from registers, 8380 (79.4%) met inclusion criteria. The overall rate of stillbirth was 25 per 1000 deliveries (95% confidence interval 22-29). We found no significant association between timing of maternal cART initiation and stillbirth. In multivariable models, older maternal age, male sex of the infant, breech vaginal delivery, delivery at < 34 weeks of gestation and experience of any maternal obstetric complication were associated with higher odds of stillbirth. Deliveries managed by a mission hospital or health centre were associated with lower odds of stillbirth. Pregnant women's exposure to cART, regardless of time of its initiation, was not associated with increased odds of stillbirth. Evaluer l'association entre le moment d'initiation de l’ART de combinaison (cART) maternel et la mortinaissance chez les femmes enceintes infectées par le VIH dans le programme Option B+ du Malawi. MÉTHODES: Etude de cohorte de femmes enceintes infectées par le VIH qui ont accouché de bébés singletons vivants ou mort-nés à 28 mois ou plus de grossesse, en utilisant les données de routine des registres de maternité entre le 1 L'exposition des femmes enceintes au cART quel que soit le moment de son initiation, n'a pas été associée à une probabilité accrue de mortinatalité.
Autres résumés
Type: Publisher
(fre)
Evaluer l'association entre le moment d'initiation de l’ART de combinaison (cART) maternel et la mortinaissance chez les femmes enceintes infectées par le VIH dans le programme Option B+ du Malawi. MÉTHODES: Etude de cohorte de femmes enceintes infectées par le VIH qui ont accouché de bébés singletons vivants ou mort-nés à 28 mois ou plus de grossesse, en utilisant les données de routine des registres de maternité entre le 1
Identifiants
pubmed: 30891866
doi: 10.1111/tmi.13233
pmc: PMC7137352
mid: NIHMS1018986
doi:
Substances chimiques
Anti-Retroviral Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
727-735Subventions
Organisme : Swiss National Science Foundation
ID : 163878
Pays : Switzerland
Organisme : Bill & Melinda Gates Foundation
ID : OPP1090200
Pays : United States
Organisme : NIAID NIH HHS
ID : U01AI069924
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069924
Pays : United States
Informations de copyright
© 2019 John Wiley & Sons Ltd.
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