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Floridia M, Masuelli G, Tassis B, et al. Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018. Mediterr J Hematol Infect Dis. 2019;11(1):e2019050doi: 10.4084/MJHID.2019.050.
Floridia, M., Masuelli, G., Tassis, B., Tamburrini, E., Savasi, V., Sansone, M., Spinillo, A., Liuzzi, G., Antoni, A. D., Dalzero, S., Franceschetti, L., Simonazzi, G., Maso, G., Francisci, D., Pinnetti, C., & Ravizza, M. (2019). Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018. Mediterranean journal of hematology and infectious diseases, 11(1), e2019050. https://doi.org/10.4084/MJHID.2019.050
Floridia, Marco, et al. "Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018." Mediterranean journal of hematology and infectious diseases vol. 11,1 (2019): e2019050. doi: https://doi.org/10.4084/MJHID.2019.050
Floridia M, Masuelli G, Tassis B, Tamburrini E, Savasi V, Sansone M, Spinillo A, Liuzzi G, Antoni AD, Dalzero S, Franceschetti L, Simonazzi G, Maso G, Francisci D, Pinnetti C, Ravizza M. Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018. Mediterr J Hematol Infect Dis. 2019 Sep 01;11(1):e2019050. doi: 10.4084/MJHID.2019.050. eCollection 2019. PMID: 31528316; PMCID: PMC6736172.
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Mediterr J Hematol Infect Dis. 2019 Sep 01;11(1):e2019050. doi: 10.4084/MJHID.2019.050. eCollection 2019.

Pregnancy Loss in Women with HIV is not Associated with HIV Markers: Data from a National Study in Italy, 2001-2018.

Mediterranean journal of hematology and infectious diseases

Marco Floridia, Giulia Masuelli, Beatrice Tassis, Enrica Tamburrini, Valeria Savasi, Matilde Sansone, Arsenio Spinillo, Giuseppina Liuzzi, Anna Degli Antoni, Serena Dalzero, Laura Franceschetti, Giuliana Simonazzi, Gianpaolo Maso, Daniela Francisci, Carmela Pinnetti, Marina Ravizza

Affiliations

  1. National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy.
  2. Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and University of Turin, Turin, Italy.
  3. Obstetrics and Gynecology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico di Milano, Milan, Italy.
  4. Department of Infectious Diseases, Catholic University and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  5. Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy.
  6. Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy.
  7. Department of Obstetrics and Gynaecology, IRCCS S. Matteo, Pavia, Italy.
  8. I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
  9. Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy.
  10. Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
  11. Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.
  12. Department of Medical and Surgical Sciences, Policlinico Sant'Orsola-Malpighi and University of Bologna, Bologna, Italy.
  13. Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
  14. Clinic of Infectious Diseases, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.

PMID: 31528316 PMCID: PMC6736172 DOI: 10.4084/MJHID.2019.050

Abstract

BACKGROUND: There is limited information on pregnancy loss in women with HIV, and it is still debated whether HIV-related markers may play a role.Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease.

METHODS: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (<22 weeks) and stillbirth (≥22 weeks). Possible associations of pregnancy loss were evaluated in univariate and multivariate analyses.

RESULTS: Among 2696 eligible pregnancies reported between 2001 and 2018, 226 (8.4%) ended in pregnancy loss (miscarriage 198, 7.3%; stillbirth 28, 1.0%). In multivariate analyses, only older age (adjusted odds ratio [AOR] per additional year of age: 1.079, 95% confidence interval [CI] 1.046-1.113), HIV diagnosis before pregnancy (AOR: 2.533, 95%CI 1.407-4.561) and history of pregnancy loss (AOR: 1.625, 95%CI 1.178-2.243) were significantly associated with pregnancy loss. No significant association with pregnancy loss was found for parity, coinfections, sexually transmitted diseases, hypertension, smoking, alcohol and substance use, CD4 cell count, HIV-RNA viral load, and CDC HIV stage.

CONCLUSIONS: Older women and those with a previous history of pregnancy loss should be considered at higher risk of pregnancy loss. The severity of HIV disease and potentially modifiable risk factors did not increase the risk of pregnancy loss.

Keywords: CD4 cell count; HIV; Miscarriage; Pregnancy loss; Stillbirth

Conflict of interest statement

Competing interests: The authors have declared that no competing interests exist.

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