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• W4281700512 endingPage "1019" @default.
• W4281700512 startingPage "1007" @default.
• W4281700512 abstract "Objective: The aim of this study was to understand predictors of adverse pregnancy outcomes (APOs) among women on antiretroviral treatment (ART). Design: A longitudinal cohort Methods: Participants from the Mobile WAChX trial were evaluated for APOs, including stillbirth (fetal death at ≥20 weeks’ gestation), preterm birth (PTB, livebirth at <37 weeks’ gestation,) and neonatal death (NND, ≤28 days after live birth). Predictors were determined by univariable and multivariable Cox proportional hazards and log-binomial models. Results: Among 774 women included, median age was 27 years and 29.0% had unsuppressed HIV viral load (>1000 copies/ml) at enrollment. Half (55.1%) started ART prepregnancy, 89.1% on tenofovir-based regimens. Women with depression had a higher risk of stillbirth (adjusted hazard ratio [aHR] 2.93, 95% confidence interval (95% CI) 1.04–8.23), and women with lower social support score had higher risk of late stillbirth (aHR 11.74, 2.47–55.86). Among 740 livebirths, 201 (27.2%) were preterm and 22 (3.0%) experienced NND. PTB was associated with unsuppressed maternal viral load (adjusted prevalence ratio [aPR] 1.28, 95% CI 1.02–1.61), intimate partner violence (IPV) in pregnancy (aPR 1.94, 95% CI 1.28–2.94), and history of any sexually transmitted infection (STI) (aPR 1.63, 95% CI 1.06–2.51). NND was associated with PTB (aPR 2.53, 95% CI 1.10–5.78) and STI history (aPR 4.25, 95% CI 1.39–13.06). Most associations retained significance in the subgroup of women with viral suppression. Conclusion: Maternal viremia during pregnancy predicted PTB as did IPV, lower education, and STI history, while psychosocial stressors predicted stillbirth. Implementing mental health services, ART adherence, partner support, and routine STI screening and treatment could reduce APOs among women with HIV in sub-Saharan Africa settings." @default.
• W4281700512 created "2022-06-13" @default.
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• W4281700512 date "2022-03-04" @default.
• W4281700512 modified "2023-09-23" @default.
• W4281700512 title "Predictors of adverse pregnancy outcomes among Kenyan women with HIV on antiretroviral treatment in pregnancy" @default.
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• W4281700512 doi "https://doi.org/10.1097/qad.0000000000003215" @default.
• W4281700512 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/35652673" @default.
• W4281700512 hasPublicationYear "2022" @default.
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