Pregnancy outcomes in HIV-infected women
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260880Keywords:
Antiretroviral therapy, HIV in pregnancy, Mother-to-child transmission, NACO, PPTCTAbstract
Background: HIV infection during pregnancy remains a significant public health concern in India despite a declining prevalence. Mother-to-child transmission (MTCT) continues to be the primary source of pediatric HIV infection. Early identification of HIV-positive pregnant women and timely initiation of antiretroviral therapy (ART) under the Prevention of Parent-to-Child Transmission (PPTCT) programme are critical for reducing MTCT and improving maternal and neonatal outcomes.
Methods: A retrospective observational study was conducted at SVP Hospital and SCL Hospital from January 2015 to December 2024. Fifty HIV-seropositive pregnant women attending antenatal care or presenting in labor and receiving ART were included. HIV testing, counseling, ART initiation, and follow-up were performed in accordance with National AIDS Control Organization (NACO) guidelines. Maternal demographics, obstetric complications, CD4 counts, mode of delivery, and neonatal outcomes, including HIV status at 18 months, were analyzed.
Results: Among the 50 women, 28% were newly diagnosed during labor, while 72% were known HIV-positive cases. Most women were aged 25-30 years (44%) and were primigravida (44%). Maternal complications included anemia (40%), fetal growth restriction (26%), pulmonary tuberculosis (14%), and preterm delivery (16%). The live birth rate was 92%. Cesarean section was performed in 84.7% of cases for obstetric indications. CD4 counts were >200 cells/mm³ in 98% of women. Nevirapine prophylaxis was administered to all live-born infants. Of the 46 infants tested at 18 months, only one (1%) was HIV-positive. Low birth weight was observed in 32.6% of neonates, and neonatal mortality was 2.2%.
Conclusions: Effective implementation of PPTCT services, including universal antenatal screening, early ART initiation, institutional delivery, neonatal prophylaxis, and follow-up per NACO guidelines, significantly reduces MTCT of HIV. Strengthening early antenatal registration and ART adherence can further improve outcomes.
References
González R, Rupérez M, Sevene E, Vala A, Maculuve S, Bulo H, et al. Effects of HIV infection on maternal and neonatal health in southern Mozambique: a prospective cohort study after a decade of antiretroviral drugs roll out. PLoS One. 2017;12(6):e0178134. DOI: https://doi.org/10.1371/journal.pone.0178134
Sambo TT, Adewole ND, Isah DA, Nongo BH. HIV in pregnancy and feto-maternal outcome. J Clin Epidemiol Public Health. 2023;1(4):1-6.
Aderonmu TSB, Adolphus T. Students’ level of scientific literacy and academic performance in physics concepts in Rivers State, Nigeria. Int J Res Innov Appl Sci (IJRIAS). 2021;6(1):1-4.
Daver RG, Chhabra M. Multidrug regimen for prevention of mother-to-child transmission in human immunodeficiency virus-positive mothers in India-from prevention toward elimination. J South Asian Feder Obst Gynae. 2019;11(1):50-7. DOI: https://doi.org/10.5005/jp-journals-10006-1649
Singh S. Food crisis and AIDS: the Indian perspective. Lancet. 2003;362(9399):1938-9. DOI: https://doi.org/10.1016/S0140-6736(03)14980-X
National AIDS Control Organization (NACO). Annual report 2002-2004. New Delhi: Ministry of Health and Family Welfare, Government of India; 2004.
Malpani P, Biswas M, Kale V. Outcome of children born to human immunodeficiency virus-positive mothers: a retrospective study. Ind J Child Heal. 2016;3(3):244-7. DOI: https://doi.org/10.32677/IJCH.2016.v03.i03.016
Khokar N, Jethwa D, Lunagaria R, Panchal N. Seroprevalence of hepatitis B, hepatitis C, syphilis and HIV among pregnant women in a tertiary care hospital, Gujarat, India. Int J Curr Microbiol Appl Sci. 2015;4(9):188-94.
Giri PA, Bangal VB, Phalke DB. Prevalence of HIV among rural pregnant women attending antenatal clinic at a tertiary care hospital. Int J Biol Med Res. 2012;3(2):1466-8. DOI: https://doi.org/10.4103/2249-4855.118662
Ashtagi GS, Metgud CS, Walvekar PR, Naik VA. Prevalence of HIV among rural pregnant women attending PPTCT services at KLE Hospital, Belgaum. Al Ameen J Med Sci. 2011;4(1):45-8.
Hirsch HH, Kaufmann G, Sendi P, Battegay M. Immune reconstitution in HIV-infected patients. Clin Infect Dis. 2004;38(8):1159-66. DOI: https://doi.org/10.1086/383034
Kulkarni S, Palve T, Bulchandani P, Devnikar K, Thatikonda R. HIV in pregnancy: a study of 30 cases in a tertiary care center in Mumbai, India. Int J Reprod Contracept Obstet Gynecol. 2023;12(1):143-6. DOI: https://doi.org/10.18203/2320-1770.ijrcog20223485
National AIDS Control Organization (NACO). Ministry of Health and Family Welfare, Government of India. National technical guidelines on antiretroviral treatment, 2018. Available at: https://naco.gov.in/sites/default/files/NACO%20-%20National%20Technical%20Guidelines%20on%20ART_October%202018%20%281%29.pdf. Accessed 01 January 2026.
Dadhwal V, Sharma A, Khoiwal K, Deka D, Sarkar P, Vanamail P. Pregnancy outcomes in HIV-infected women: experience from a tertiary care center in India. Int J MCH AIDS. 2017;6(1):75-81. DOI: https://doi.org/10.21106/ijma.196
Downloads
Published
How to Cite
Issue
Section
