Mid-trimester cervical length not associated with HIV status among pregnant women in Botswana.
Adult
Botswana
Cervical Length Measurement
Cervix Uteri
/ diagnostic imaging
Cohort Studies
Female
HIV
HIV Infections
/ pathology
Humans
Obstetric Labor, Premature
/ prevention & control
Pregnancy
Pregnancy Complications
Pregnancy Trimester, Second
Premature Birth
/ prevention & control
Prenatal Care
Prospective Studies
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
10
2019
accepted:
09
02
2020
entrez:
12
3
2020
pubmed:
12
3
2020
medline:
8
7
2020
Statut:
epublish
Résumé
HIV-infected women on antiretroviral therapy have a higher risk of preterm birth than HIV-uninfected women in Botswana. To better understand the mechanism for preterm birth among HIV-infected women, we evaluated whether mid-trimester cervical length differed by HIV status as cervical shortening is associated with an increased risk for preterm birth. We conducted a prospective cohort study among pregnant women receiving care at the Scottish Livingstone Hospital in Molepolole, Botswana. Consecutive women referred for routine obstetrical ultrasound were consented and enrolled if between 22w0d and 24w6d by ultrasound biometry. Blinded to maternal HIV status, an obstetrician measured transvaginal cervical length using standardized criteria. Cervical length, as well as the proportion of women with a short cervix (<25mm), were compared among HIV-infected and HIV-uninfected women. The acceptability of transvaginal ultrasound was also evaluated. Between April 2016 and April 2017, 853 women presenting for obstetric ultrasound were screened, 187 (22%) met eligibility criteria, and 179 (96%) were enrolled. Of those enrolled, 50 (28%) were HIV-infected (86% on antiretroviral therapy), 127 (71%) were HIV-uninfected, and 2 (1%) had unknown HIV status. There was no significant difference in mean cervical length between HIV-infected and HIV-uninfected women (32mm vs 31mm, p = 0.21), or in the proportion with a short cervix (10% vs 14%, p = 0.44). Acceptability data was available for 115 women who underwent a transvaginal ultrasound exam. Of these, 112 of 115 (97%) women deemed the transvaginal scan acceptable. The increased risk of preterm birth observed among HIV-infected women receiving antiretroviral therapy in Botswana is unlikely associated with mid-trimester cervical shortening. Further research is needed to understand the underlying mechanism for preterm birth among HIV-infected women.
Identifiants
pubmed: 32160214
doi: 10.1371/journal.pone.0229500
pii: PONE-D-19-28835
pmc: PMC7065819
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0229500Subventions
Organisme : FIC NIH HHS
ID : D43 TW009610
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI131924
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD095766
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Am J Obstet Gynecol. 1997 Feb;176(2):478-89
pubmed: 9065202
J Antimicrob Chemother. 2009 Nov;64(5):895-900
pubmed: 19706669
J Infect Dis. 1999 Mar;179(3):567-75
pubmed: 9952362
BMC Womens Health. 2017 Jul 27;17(1):54
pubmed: 28750613
S Afr Med J. 2005 Sep;95(9):691-5
pubmed: 16327930
Lancet. 1999 Sep 4;354(9181):795-802
pubmed: 10485720
N Engl J Med. 2010 Jun 17;362(24):2282-94
pubmed: 20554983
Obstet Gynecol. 2017 Mar;129(3):536-541
pubmed: 28178045
Am J Obstet Gynecol. 2013 Mar;208(3):223.e1-7
pubmed: 23433326
Clin Infect Dis. 2012 May;54(9):1348-60
pubmed: 22460969
AIDS. 2007 May 11;21(8):1019-26
pubmed: 17457096
J Infect Dis. 2010 Apr 1;201(7):1035-44
pubmed: 20196654
J Immunol. 1995 Jul 1;155(1):128-33
pubmed: 7541410
N Engl J Med. 1994 Nov 3;331(18):1173-80
pubmed: 7935654
AIDS. 2012 Jan 2;26(1):37-43
pubmed: 22008651
JAMA Pediatr. 2017 Oct 2;171(10):e172222
pubmed: 28783807
N Engl J Med. 2002 Jun 13;346(24):1863-70
pubmed: 12063370
Ultrasound Obstet Gynecol. 2007 Oct;30(5):687-96
pubmed: 17899572
J Infect Dis. 2012 Dec 1;206(11):1695-705
pubmed: 23066160
Ultrasound Obstet Gynecol. 2007 Oct;30(5):697-705
pubmed: 17899571
J Neuroimmunol. 2000 Sep 1;109(1):30-3
pubmed: 10969178
Ultrasound Obstet Gynecol. 2011 Jul;38(1):18-31
pubmed: 21472815
J Reprod Immunol. 2006 Jun;70(1-2):143-50
pubmed: 16423410
Radiology. 1984 Aug;152(2):497-501
pubmed: 6739822
J Infect Dis. 2006 May 1;193(9):1191-4
pubmed: 16586353
Int J Gynaecol Obstet. 2019 Aug;146(2):206-211
pubmed: 30973655
Ann Afr Med. 2015 Jan-Mar;14(1):52-6
pubmed: 25567696
J Infect Dis. 2011 Aug 15;204(4):506-14
pubmed: 21791651
N Engl J Med. 1996 Feb 29;334(9):567-72
pubmed: 8569824
BJOG. 2010 Oct;117(11):1399-410
pubmed: 20716250
J Infect Dis. 2006 May 1;193(9):1195-201
pubmed: 16586354
Biochem Biophys Res Commun. 1998 Apr 28;245(3):933-8
pubmed: 9588218
Int J Gynaecol Obstet. 2011 Oct;115(1):20-5
pubmed: 21767835
Lancet. 2008 Jan 5;371(9606):75-84
pubmed: 18177778
J Reprod Immunol. 2013 Jun;98(1-2):52-60
pubmed: 23489467
N Engl J Med. 2007 Aug 2;357(5):462-9
pubmed: 17671254
Immunol Today. 1993 Jul;14(7):353-6
pubmed: 8363725