Effect of antenatal retroviral therapy on feto-maternal outcome in human immunodeficiency virus seropositive patients


  • Swati Trivedi Department of Obstetrics and Gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India
  • Oby Nagar Department of Obstetrics and Gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India
  • Shashank Trivedi Department of Pediatrics, K. E. M., Pune, Maharashtra, India
  • Prasoon Rastogi Department of Medicine, K. G. M. U., Lucknow, Uttar Pradesh, India




Adverse fetal outcomes, ART, Human immunodeficiency virus, Term of delivery


Background: To study the effect of HIV and duration of ART on term of delivery, newborn birth weight and adverse fetal outcomes.

Methods: Prospective comparative study of 40 HIV seropositive pregnant females with varying duration of ART (tenofovir 300 mg + lamivudine 300 mg + efavirenz 600 mg) and HIV seronegative pregnant females attending ANC and delivering in department of obstetrics and gynecology at S. M. S. Medical College, Jaipur, Rajasthan, India.

Results: Most HIV seropositive patients were in age group 25 to 30 years and more number were booked in comparison to unbooked. Adverse fetal outcomes were seen more in HIV seropositive patients and they were found to be statistically significant (p=0.029). No relationship could be derived of duration of ART on either the birth weight or term of delivery or adverse fetal outcomes.

Conclusions: Maternal HIV infection was significantly found associated with adverse fetal outcome and this was not affected by the use of ART.


Park K. Epidemiology of communicable diseases, Park’s textbook of preventive and social medicine. Bhanot Publishers;2015;5:343-347.

Larry J. Harrison’s Principles of Internal Medicine Chapter 197: Human Immunodeficiency Virus Disease: AIDS and related disorders, 20th edition; 2018;1393-1402.

NACO (National AIDS Control Organization) Annual Report NACO 2016-17 English. Available at: http://naco.gov.in/documents/annual-reports. Accessed on 4th January 2020.

HIV Facts and figures: NACO, Available at - http://naco.gov.in/hiv-facts-figures Accessed on 4th January 2020.

National AIDS Control Organization Ministry of Health and Family Welfare Government of India: National technical guidelines on anti-retroviral treatment. NACO: 2018:7:50-9.

Dwivedi S, Jahan U, Dwivedi GN, Gupta N, Verma K, Sharma B, et al. Perinatal outcome in HIV infected pregnant women at tertiary care Hospital in north India: eleven years retrospective study. Int J Recent Sci Res.2017;8(5):16801-05.

Prameela RC, Asha MB, Bhanumathi, Geetha T, Vasumathy S, Shankar R. Maternal and Fetal Outcome in HIV pregnant women, 5 years study at tertiary hospital. J Dent Med Sci. 2015;14(3):53-6.

Ezechi OC, Gab Okafor CV, Oladele DA, Kalejaiye OO, Oke BO, Ohowodo HO, et al. Pregnancy, obstetrics and neonatal outcomes in HIV positive Nigerian women. Afr J Reprod Health. 2013;17(3): 160-8.

Schulte J, Dominguez K, Sukalac T, Bohannon B, Fowler MG. Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004. Pediatr. 2007;119:e900-e906.

Coley JL, Msamanga GI, Fawzi M. The association between maternal HIV-1 infection and pregnancy outcomes in Dar es Salaam Tanzania. BJOG. 2001;108(11):1125-33.

Bucceri A, Luchini L, Rancilio L. Pregnancy outcome among HIV positive and negative intravenous drug users. Eur J Obstet Gynecol Reprod Biol. 1997;72(2):169-74.

Muhangi L, Lule SA, Mpairwe H. Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe Uganda. Public Health Nutr. 2013;16(9):1548-57.

Brocklehurst P, French R. The association between maternal HIV infection and perinatal outcome: a systemic review of the literature and meta-analysis. Br J Obstet Gynecol. 1998;105:839-48.

Xiao PL, Zhou YB, Chen Y, Yang MX, Song XX, Shi Y, et al. Association between maternal HIV infection and low birth weight and prematurity: a meta-analysis of cohort studies. BMC Preg Childbirth. 2015;15:246.

Townsend C, Schulte J, Thorne C. Antiretroviral therapy and preterm delivery-a pooled analysis of data from the United States and Europe. BJOG. 2010;117(11):1399-410.

Santini-Oliveira M, Friedman RK, Veloso VG. Incidence of antiretroviral adverse drug reactions in pregnant women in two referral centers for HIV prevention of mother-to-child-transmission care and research in Rio de Janeiro Brazil. Braz J Infect Dis. 2014;18(4):372-8.

Papp E, Mohammadi H, Loutfy MR. HIV protease inhibitor use during pregnancy is associated with decreased progesterone levels, suggesting a potential mechanism contributing to fetal growth restriction. J Infect Dis. 2015;211(1):10-8.

Sibiude J, Warszawski J, Tubiana R. Premature delivery in HIV-infected women starting protease inhibitor therapy during pregnancy: role of the ritonavir boost? Clin Infect Dis. 2012;54(9):1348-60.

Van der Merwe K, Hoffman R, Black V. Birth outcomes in South African women receiving highly active antiretroviral therapy: a retrospective observational study. J Int AIDS Soc. 2011;14(1):42.

Townsend CL, Cortina-Borja M, Peckham CS, Tookey PA. Antiretroviral therapy and premature delivery in diagnosed HIV-infected women in the United Kingdom and Ireland. AIDS. 2007;1019-26.

Kennedy D. The effect of maternal HIV status on perinatal outcome at Mowbray Maternity Hospital and referring midwife obstetric units, Cape Town. SAJOG. 2012;18:1.

Kumar RM, Uduman SA, Khurrana AK. Impact of maternal HIV-1 infection on perinatal outcome. Int J Gynaecol Obstet. 1995; 49:137-43.

Ellis J, Williams H, Graves W. Human immunodeficiency virus infection is a risk factor for adverse perinatal outcome. Am J Obstet Gynecol. 2002;186:903-6.

Gautam S, Shah T. Study of perinatal outcome in human immunodeficiency virus positive women. Int J Reprod Contracept Obstet Gynecol. 2016;5(8):2587-90.

Haeri S, Shauer M, Dale M, Leslie J, Baker AM, Saddlemire S, Boggess K. Obstetric and newborn infant outcomes in human immunodeficiency virus-infected women who receive highly active antiretroviral therapy. Am J Obstet Gynecol. 2009;201:315.e1-5.

Parisaei M, Anderson J, Erskine KJ, Gann S. Experience of delivering women with HIV in an inner-city London hospital. Int J STD AIDS. 2007;18(8):227-30.

Patil S, Bhosale R, Sambarey P, Gupte N, Suryavanshi N, Sastry J, et al. Impact of maternal human immunodeficiency virus infection on pregnancy and birth outcomes in Pune, India. AIDS Care. 2011;23(12):1562-69.

Fekadu M, Alemayehu W, Mesganaw F, Eta E. Antiretroviral therapy and pregnancy outcomes in developing countries: a systematic review. Int J MCH AIDS. 2015;3(1):31-43.






Original Research Articles