Factors associated with miscarriage and perinatal mortality in women with HIV infection

Abstract

The purpose of this study was to evaluate risk factors associated with miscarriage (defined as the interruption of pregnancy before the 20th week of gestation) and perinatal mortality (defined as fetal death from the 21st week of pregnancy until neonatal stage, occurring until the first week of life) in HIV-infected pregnant women. This retrospective, cross-sectional study included HIV-infected pregnant women from Brazil aged between 18 and 47 years, who had miscarriage, vaginal delivery, or delivery by cesarean section. Data on miscarriage or perinatal mortality, sociodemographic characteristics, clinical conditions, and treatment were obtained. Statistical analyses included the use of binary logistic regression. In this cohort, the prevalence of miscarriage was 6.1% and the perinatal mortality rate was 4.0%. Risk factors for miscarriage included drug use (OR = 6.23; CI = 0.5 to 73.1), multiple gestation (OR = 3.06; CI = 0.9 to 10.9), and lack of prenatal care (OR = 18.42; IC = 3.9 to 87.6). Moreover, risk factors for perinatal mortality included drug use (OR = 1.03; IC = 0.9 to 1.1), vaginal delivery (OR = 5.56; CI = 1.2 to 26.1), and the absence of antiretroviral use during labor (OR = 17.77; CI = 3.9 to 81.8). In order to reduce the rates of miscarriage and perinatal mortality in HIV-infected pregnant women, actions aimed at eliminating drug use during pregnancy, ensuring adequate prenatal care, performing elective cesarean section delivery, and using antiretroviral medications during labor should be prioritized. .

Keywords: Pregnant women, abortion, miscarriage, perinatal mortality, risk factors.