1. Home
  2. Vol 52, No 1 (2020)
  3. Indarti

Pregnancy Profile and Infant Outcomes Among HIV Infected Women Who Delivered in Cipto Mangunkusumo Hospital

Junita Indarti, Evy Yunihastuti, Nia Kurniati, Bella Aprilia, Danang T Pamungkas, Ariel T Chiprion, Mega A Ginting, Saiful Rizal, Citra Dewi, Lieke Handayani

Abstract


Background: HIV infection in pregnancy is a big concern for the future of our nation. The virus can be transmitted to the baby through pregnancy, childbirth and during breastfeeding which rendering to early detection and intervention. The aim of this study was to describe the transmission prevention cascade among our patient. Methods: this was a retrospective cohort study of HIV vertical transmission. The inclusion criteria was pregnant women with HIV infection who have antenatal care in Cipto Mangunkusumo Hospital from January 2013 up to December 2018. Data was retrieved from medical record, HIV registry and laboratory results. The included data were demographic, risk of infection, obstetrical data, mode of delivery, ARV history, laboratory history in mother and infant. Data was presented as descriptive. Results: there was 138 HIV pregnant women included as study subjects. Most women were at 25-29 years old (39.85%), as housewife (41.30%), with history of more than one sexual partners (50.73%). The subjects was mostly multigravida (77.5%), first visit to RSCM in third trimester (98.6%), with history of antenatal care >4 times (48.6%), singleton fetus (99.3%), and delivered by C-section (84.1%). HIV diagnosis was done during pregnancy (73.53%), and already on antiretroviral (ARV) for more than 6 months (50.7%). There was 78% subjects with CD4 (24% subjects with <200 cells/mL) and 84% with viral load data (36% with viral load >200 copies/uL). Around 72.5% infants born with birth weight 2500-3500g. Almost all infant received ARV prophylaxis (97.9%) and formula feeding. PCR HIV was examined on 16 infant on 6 weeks of age and and 13 on 6 month age. There was 1 infant with viral load results >400 copies/ml which immediately refered to Pediatric HIV clinic. Bivariate analysis showed significant correlation between maternal ARV consumption and infant result at birth (P=0.05). Maternal CD4 level was not significantly correlate with neonatal virology status (P=0.12). Conclusion:HIV diagnosis in pregnant women is important, since ARV administration on early pregnancy significantly reduce vertical transmission. ARV prophylaxis protocols is important to prevent HIV infection on infant.

 


Keywords


HIV in pregnancy; obstetric outcome; infant outcome

References


CDC. HIV/AIDS surveillance report. United States: Department of health and human services, 2009.

UNAIDS. Global statistics 2015 2016 [cited 2019 16 January]. Available from: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf

Finger JL, Clum GA, Trent ME, Ellen JM. Desire for pregnancy and risk behavior in young HIV-positive women. AIDS Patient Care STDS. 2012;26(3):173-80.

Vitry-Henry L, Penalba C, Beguinot B, Dschamps F. Relationship between work and HIV/AIDS status. Occup Med. 1999;49(2):115-6.

Attanasio L, Kozhimannil K, Kjerulff K. Women’s preference for vaginal birth after a first delivery by cesarean. Birth. 2018 (Jul 27).

Boatin A, Schlotheuber A, Hosseinpoor A. Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries. BMJ. 2018;360(k55).

Kyaw K, Oo M, Kyaw N, Phyo K, Aung T, Mya T. Low mother-to-child HIV transmission rate but high loss-to-follow-up among mothers and babies in Mandalay, Myanmar; a cohort study. Plos one. 2017;12(9):e0184426.

Charurat M, Datong P, Matawal B, A Ajene A, Blattner W, Abimiku A. Timing and determinants of mother-to-child transmission of HIV in Nigeria. Int J Gynaecol Obstet. 2009;106(1):8-13.

Nkenfou N, Temgoua E, Ndzi E, Mekue L, Ngoufack M, Dambaya B. Maternal age, infant age, feeding options, single/multiple pregnancy, type of twin sets and mother-to-child transmission of HIV. J Trop Pedia. 2018;0:1-7.

Eriksson J, Kaiantie E, Osmond C, et al. Boys live dangerously in the womb. Am J Hum Biol. 2010;22:330-5.

Makunyane L, Moodley J, Titus M. HIV transmission in twin pregnancy: maternal and perinatal outcomes. S Afr J Infect Dis. 2017;32(2):54-6.

Beyene G, Dadi L, Mogas S. Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study. BMC Infect Dis. 2018;18:327.

UNAIDS. The gap report-Join united nations programme on HIV/AIDS 2014 [cited 2019 16 January]. Available from: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf.

ACOG. Labor and delivery management of women with human immunodeficiency virus infection. J Obstet Gynaecol. 2018;132:e131-37.

UNAIDS. The gap report-Join united nations programme on HIV/AIDS 2014 [cited 2019 16 January]. Available from: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf.

Costa Z, Machado G, Avelino M, et al. Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil. BMC Infect Dis. 2009;9:116.

Money D, Tulloch K, Boucoiran I, Caddy S. Guidelines for the care of pregnant women living with HIV and interventions to reduce perinatal transmission. J Obstet Gynaecol Can. 2014;36(8 eSuppl A):S1-S46.

Tan MK. Karakteristik ibu hamil dengan HIV/AIDS di Rumah Sakit Umum Pusat Haji Adam Malik Medan Tahun 2012-2016. J USU. 2017;2(5).

DEPKES RI. Modul pelatihan pencegahan penularan HIVdari ibu ke bayi. 2008.

Suherlim R. Karakteristik penderita HIV pada ibu hamil di Klinik Prevention Mother to Child Transmission (PMTCT) Poli Kebidanan RSUP Sanglah Denpasar Periode Juli 2013 – Juni 2014. Jurnal Mahasiswa PSPD FK Universitas Tanjungpura. 2015;1(3).

Suhalmi D, Savira M, Krisnadi SR. Pencegahan dan penatalaksanaan infeksi HIV pada kehamilan. Majalah Kedokteran Bandung. 2009.

Zainul AA. Gambaran faktor risiko kejadian HIV-AIDS pada usia produktif di Puskesmas Jumpandang Baru dan RSUP Dr. Wahidin Sudirohusodo Makassar Periode 2011-2012 (tidak dipublikasi): Universitas Islam Negeri Alaudin; 2012.

Siegfried N, van der Merwe L, Brocklehurst P, Sint TT. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane database of systematic reviews. 2011;7. Art. No.: CD003510. DOI: 10.1002/14651858.CD003510.pub3.


Full Text: PDF

Refbacks

  • There are currently no refbacks.