Obstetric and newborn infant outcomes in human immunodeficiency virus-infected women who receive highly active antiretroviral therapy.

OBJECTIVE: Our aim was to examine perinatal outcomes in women who are infected with human immunodeficiency virus (HIV) and who receive highly active antiretroviral therapy compared with the general population. STUDY DESIGN: In this retrospective cohort study, we compared 151 HIV-positive and 302 HIV-negative women. We defined highly active antiretroviral therapy as concomitant use of at least 3 antiretroviral drugs. We calculated frequencies and odds ratios for adverse pregnancy outcomes. RESULTS: Compared with control subjects, smoking (odds ratio, 4.62; 95% confidence interval [CI], 2.58-8.27), drug abuse (odds ratio, 5.48; 95% CI, 2.21-13.59), and spontaneous preterm birth (adjusted odds ratio, 2.27; 95% CI, 1.22-4.25) were more common among HIV-positive women. HIV-positive women were more likely to deliver a small-for-gestational-age infant, but this was due to higher tobacco and cocaine use. Neonatal outcomes were otherwise similar. CONCLUSION: HIV-positive women are at increased risk for preterm birth and lower birthweight infants; therefore, antenatal surveillance should include fetal growth assessment. Highly active antiretroviral therapy use does not increase maternal complications.

A comparison of birth outcomes among US-born and non-US-born Hispanic Women in North Carolina.

OBJECTIVE: To compare birth outcomes between non-US-born and US-born Hispanic women in North Carolina (NC). METHODS: A retrospective comparison of birth outcomes from linked NC birth/death certificate data (1993-1997) for 22,234 Hispanic births by mother's place of birth was conducted. RESULTS: Mexico-born Hispanic women (58%) had significantly fewer medical risks, tobacco or alcohol use during pregnancy; however, they also had significantly less education and prenatal care than US-born Hispanic women (21%). Infant mortality rate, low birth weight, and prematurity were low and did not differ significantly. Lethal anomalies were the primary cause of infant mortality in non-US-born Hispanics versus Sudden Infant Death Syndrome (SIDS) in US-born Hispanics. CONCLUSIONS: Despite increased risk factors among US-born women, we found no difference in Hispanic birth outcomes in NC by mother's place of birth. These data contradict national data and may be related to findings of both positive and negative aspects of acculturation in NC.

Infant mortality, low birth weight, and prematurity among Hispanic, white, and African American women in North Carolina.

OBJECTIVES: The study was undertaken to compare Hispanic birth outcomes with those of white and African American women in North Carolina and to examine variables associated with adverse birth outcomes among Hispanic women. STUDY DESIGN: Retrospective comparison of birth outcomes by ethnicity/race, from linked birth/infant death certificates in North Carolina (1993-1997) was conducted. Multivariate, binary logistic regression and chi(2) analysis were used to examine relationships between available medical and sociodemographic index values and composite birth outcomes among Hispanic women. RESULTS: Infant mortality rates were lowest among Hispanic women. Low birth weight and prematurity rates were similar to those of white women and lower than those of African American women. Variables significantly related to healthy composite birth outcomes among Hispanic women included higher education, no preterm delivery history, prenatal care, marriage, and no daily tobacco use. CONCLUSION: Hispanic birth outcomes in North Carolina were better than those of African American women and similar to those of white women, despite use of prenatal care and socioeconomic characteristics similar to African American women.