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Pregnancy outcomes and antiretroviral treatment in a national cohort of pregnant women with HIV: overall rates and differences according to nationality

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Abstract:

We used data from the main surveillance study of HIV and pregnancy in Italy to evaluate possible differences in pregnancy care and outcomes according to nationality. Among 960 women followed in 2001–06, 33.5% were of foreign nationality, mostly from African countries. Foreign women had lower rates of preconception counselling and planning of pregnancy. They had more frequently HIV diagnosed during pregnancy, with a later start of antiretroviral treatment and lower treatment rates at all trimesters but not when the entire pregnancy, including delivery, was considered. No differences were observed between the two groups in ultrasonography assessments, hospitalisations, AIDS events, intrauterine or neonatal deaths, and mode and complications of delivery. Foreign women had a slightly lower occurrence of preterm delivery and infants with low birthweight. The results indicate good standards of care and low rates of adverse outcomes in pregnant women with HIV in Italy, irrespective of nationality. Specific interventions, however, are needed to increase the rates of counselling and HIV testing before pregnancy in foreign women.

Keywords: Antiretroviral treatment; HIV; nationality; pregnancy

Document Type: Short Communication

DOI: https://doi.org/10.1111/j.1471-0528.2007.01355.x

Affiliations: 1: Department of Infectious Diseases, Catholic University, Rome, Italy 2: II Department of Obstetrics and Gynecology, Clinica L. Mangiagalli, University of Milan, Milan, Italy 3: Department of Obstetrics and Gynecology, A.O. OIRM S. Anna, University of Turin, Turin, Italy 4: O.U. of Pediatrics and Perinatal Infections, INMI L. Spallanzani, Rome, Italy 5: Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy 6: Department of Gynaecology and Obstetrics, S. Giovanni di Dio Hospital, University of Cagliari, Cagliari, Italy 7: Department of Obstetrics and Gynaecology, University of Bologna, St Orsola Malpighi General Hospital, Bologna, Italy 8: Department of Obstetrics and Gynaecology, Sacco Hospital, University of Milan, Milan, Italy 9: Department of Infectious Diseases, Azienda Ospedaliera di Parma, Parma, Italy 10: Department of Obstetrics and Gynecology, S. Paolo Hospital, University of Milan, Milan, Italy

Publication date: 2007-07-01

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