Trends in live birth rates and adverse neonatal outcomes among HIV-positive women in Ontario, Canada, 2002-2009: a descriptive population-based study

Int J STD AIDS. 2014 Nov;25(13):960-6. doi: 10.1177/0956462414526861. Epub 2014 Mar 19.

Abstract

To characterise trends in live birth rates, adverse neonatal outcomes and socio-demographic characteristics of pregnant women with diagnosed HIV between the ages of 18 and 49 in Ontario, Canada from 1 April 2002 to 31 March 2010, we conducted a population-based study. Utilising linked administrative healthcare databases we used generalised estimating equations to characterise secular trends and examine the association between live births and socio-demographic characteristics, including age, region of birth and neighbourhood income quintile. Between 2002/2003 and 2009/2010, there were 551 live births during 15,610 person-years of follow-up. The proportion of HIV-positive mothers originally from Africa or the Caribbean increased from 26.7% to 51.6% over the study period. The risk of pre-term (risk ratio 2.13, 95% confidence interval 1.74 to 2.61) and small for gestational age births (risk ratio 1.53, 95% confidence interval 1.20 to 1.94) was higher in women with HIV compared with provincial estimates for these outcomes. Women with HIV have rates of pre-term and small for gestational age births that exceed provincial estimates for these outcomes. Further research is required to identify factors mediating these disparities that are amenable to pre-natal risk reduction initiatives.

Keywords: AIDS; Canada; HIV; infectious; pre-term labour; pregnancy complications; pregnancy outcome; small for gestational age; women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Retroviral Agents
  • Birth Rate / trends*
  • Female
  • Follow-Up Studies
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / transmission
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Infectious Disease Transmission, Vertical / prevention & control
  • Logistic Models
  • Middle Aged
  • Ontario / epidemiology
  • Population Surveillance
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Outcome
  • Premature Birth / epidemiology*
  • Socioeconomic Factors
  • Young Adult

Substances

  • Anti-Retroviral Agents