Background: There is limited information on pregnancy outcomes in women with HIV who are of a more advanced maternal age.Methods: Data from a national observational study in Italy were used to evaluate the risk of nonelective cesarean section, preterm delivery, low birthweight, major birth defects, and small gestational age-adjusted birthweight according to maternal age (<35 and ≥35 years, respectively).Results: Among 1,375 pregnancies with live births, 82.4% of deliveries were elective cesarean sections, 15.8% were nonelective cesarean sections, and 1.8% were vaginal deliveries. Rates of nonelective cesarean section were similar among mothers ≥35 and <35 years (odds ratio [OR], 1.22; 95% CI, 0.90-1.65;P = .19). Preterm delivery and low birthweight were significantly more common among women ≥35 years in univariate but not in multivariate analyses. Newborns from women ≥35 and <35 years showed no differences inZ scores of birthweight, with a similar occurrence of birthweight <10th percentile (12.1% vs 12.0%; OR, 1.02; 95% CI, 0.71-1.46;P = .93). The overall rate of birth defects was 3.4% (95% CI, 2.4-4.4), with no differences by maternal age (≥35 years, 3.5%; <35 years, 3.3%; OR, 1.05; 95% CI, 0.56-1.98;P = .88).Discussion: In this study of pregnant women with HIV, older women were at higher risk of some adverse pregnancy outcomes, such as preterm delivery and low birthweight. The association, however, did not persist in multivariable analyses, suggesting a role of some predisposing factors associated with older age.

Pregnancy Outcomes in HIV-Infected Women of Advanced Maternal Age / G. Liuzzi, C. Pinnetti, M. Floridia, E. Tamburrini, G. Masuelli, S. Dalzero, M. Sansone, V. Giacomet, A.M. Degli Antoni, G. Guaraldi, A. Meloni, A. Maccabruni, S. Alberico, V. Portelli, M. Ravizza, F. Mori, P. Ortolani, E.R. Dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V. Mercurio, A. Carocci, E. Grilli, M. Zaramella, B. Mariani, G. Natalini Raponi, K. Luzi, G. Nardini, C. Stentarelli, A. Molinari, M. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, V. Fabiano, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, L. Bernini, S. Alberico, G. Maso, M. Airoud, M. Tropea, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Vicini, A. Spinillo, M. Roccio, A. Vimercati, A. Miccolis, E. Bassi, B. Guerra, F. Cervi, C. Puccetti, P. Murano, M. Contoli, M. Capretti, C. Marsico, G. Faldella, M. Sansone, P. Marinelli, A. Agangi, C. Tibaldi, L. Trentini, T. Todros, G. Masuelli, S. Garetto, I. Cetin, T. Brambilla, V. Savasi, A. Crepaldi, C. Giaquinto, M. Fiscon, R. Rinaldi, P. Grossi, L. Rizzi, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, C. Fundarò, O. Genovese, C. Cafforio, C. Pinnetti, V. Tozzi, P. Massetti, A. Casadei, A. Cavaliere, V. Finelli, M. Cellini, G. Castelli Gattinara, A. Marconi, V. Sacchi, A. De Pirro, C. Polizzi, A. Mattei, M. Pirillo, R. Amici, C. Galluzzo, S. Donnini, S. Baroncelli, M. Regazzi, P. Villani, M. Cusato, A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, S. Vella, P. Martinelli. - In: HIV CLINICAL TRIALS. - ISSN 1528-4336. - 14:3(2013 May), pp. 110-119. [10.1310/hct1403-110]

Pregnancy Outcomes in HIV-Infected Women of Advanced Maternal Age

S. Dalzero;V. Giacomet;A. Meloni;V. Mercurio
Membro del Collaboration Group
;
G. Zuccotti
Membro del Collaboration Group
;
V. Fabiano
Membro del Collaboration Group
;
S. Garetto
Membro del Collaboration Group
;
I. Cetin
Membro del Collaboration Group
;
V. Savasi
Membro del Collaboration Group
;
C. Cafforio
Membro del Collaboration Group
;
A. Marconi;A. Mattei
Membro del Collaboration Group
;
M. Moroni
Membro del Collaboration Group
;
F. Parazzini
Membro del Collaboration Group
;
2013

Abstract

Background: There is limited information on pregnancy outcomes in women with HIV who are of a more advanced maternal age.Methods: Data from a national observational study in Italy were used to evaluate the risk of nonelective cesarean section, preterm delivery, low birthweight, major birth defects, and small gestational age-adjusted birthweight according to maternal age (<35 and ≥35 years, respectively).Results: Among 1,375 pregnancies with live births, 82.4% of deliveries were elective cesarean sections, 15.8% were nonelective cesarean sections, and 1.8% were vaginal deliveries. Rates of nonelective cesarean section were similar among mothers ≥35 and <35 years (odds ratio [OR], 1.22; 95% CI, 0.90-1.65;P = .19). Preterm delivery and low birthweight were significantly more common among women ≥35 years in univariate but not in multivariate analyses. Newborns from women ≥35 and <35 years showed no differences inZ scores of birthweight, with a similar occurrence of birthweight <10th percentile (12.1% vs 12.0%; OR, 1.02; 95% CI, 0.71-1.46;P = .93). The overall rate of birth defects was 3.4% (95% CI, 2.4-4.4), with no differences by maternal age (≥35 years, 3.5%; <35 years, 3.3%; OR, 1.05; 95% CI, 0.56-1.98;P = .88).Discussion: In this study of pregnant women with HIV, older women were at higher risk of some adverse pregnancy outcomes, such as preterm delivery and low birthweight. The association, however, did not persist in multivariable analyses, suggesting a role of some predisposing factors associated with older age.
Age; Antiretroviral therapy; Birth defects; HIV; Pregnancy; Preterm delivery; Adult; Female; HIV Infections; Humans; Logistic Models; Multivariate Analysis; Pregnancy; Pregnancy Complications, Infectious; Maternal Age; Pregnancy Outcome; Pharmacology (medical); Infectious Diseases
Settore MED/17 - Malattie Infettive
mag-2013
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