Study of factors affecting maternal and fetal outcome in HIV positive women

Abstract

Background: HIV virus infection was detected first time in India in Tamil Nadu in April 1986; India has the third largest HIV epidemic in the world. In 2013, HIV prevalence in India was an estimated 0.3 percent. The pregnant women and her unborn child who are HIV reactive are mostly innocent bearers of the brunt of the infection. Mother-to-child transmission of HIV is a major route of new infections in children. Without any intervention, the risk of transmission of HIV from infected pregnant women to her child is estimated to be around 20- 45%.Early diagnosis of children born to HIV positive mother using HIV DNA PCR and treating children who are diagnosed HIV-positive with antiretroviral drugs within their first 12 weeks of life reduces mortality by 75%.

Methods: This retrospective data analytic study of HIV positive pregnant women who attended antenatal clinic and delivered at M.Y. Hospital, Indore from January 2011 to December 2013 .For screening of ANC patients ELISA method was used. For the children, HIV DNA was done by sending the dried blood smear on blot paper and was sent to the reference laboratory Kasturba Hospital, Mumbai and used for diagnosis at 6 week and 6 month.

Results: Only 50% of HIV positive children were started on ART, 20% died, 20% loss to follow up and 10% were not willing for follow up. Also 30% mothers practiced mixed feeding. Neonatal mortality rate was 54.87 per thousand live births which is more than the seronegative mothers.

Conclusions: First HIV DNA testing can be done at 72 hours to detect antenatal HIV transmission. Early testing can pick up these cases early and ensure treatment. Mixed feeding should be strongly discouraged by counseling and modern methods of communication.