Young pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001-2016, 9.0% were in women <25 years, with a significant increase over time (2001-2005: 7.0%; 2006-2010: 9.1%; 2011-2016: 12.2%, P < 0.001). Younger women had a lower rate of planned pregnancy (23.2% vs. 37.7%, odds ratio (OR) 0.50, 95% confidence interval (CI) 0.36-0.69), were more frequently diagnosed with HIV in pregnancy (46.5% vs. 20.9%, OR 3.29, 95% CI 2.54-4.25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (<25 years: 56.3%; ≥25 years: 69.0%, OR 0.58, 95% CI 0.41-0.81). During pregnancy, treatment coverage was almost universal in both age groups (98.5% vs. 99.3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

MARTINELLI, PAOLO;MARIANI, BIANCA;Grossi, P.;MELONI, ANTONIO;PIANO, PIERLUIGI;CERVI, FILIPPO;Rubino, E.;CELLINI, MATTEO;Marconi, A. M.;Ierardi, M.;DE MARTINO, MARIA CRISTINA;
2017-01-01

Abstract

Young pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001-2016, 9.0% were in women <25 years, with a significant increase over time (2001-2005: 7.0%; 2006-2010: 9.1%; 2011-2016: 12.2%, P < 0.001). Younger women had a lower rate of planned pregnancy (23.2% vs. 37.7%, odds ratio (OR) 0.50, 95% confidence interval (CI) 0.36-0.69), were more frequently diagnosed with HIV in pregnancy (46.5% vs. 20.9%, OR 3.29, 95% CI 2.54-4.25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (<25 years: 56.3%; ≥25 years: 69.0%, OR 0.58, 95% CI 0.41-0.81). During pregnancy, treatment coverage was almost universal in both age groups (98.5% vs. 99.3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.
http://journals.cambridge.org/action/displayJournal?jid=HYG
Antiretroviral treatment; HIV diagnosis; HIV testing; pregnancy; women's health; Adolescent; Cohort Studies; Female; HIV Infections; Humans; Italy; Odds Ratio; Pregnancy; Young Adult; Epidemiology; Infectious Diseases
Floridia, M.; Masuelli, G.; Tamburrini, E.; Cetin, I.; Liuzzi, G.; Martinelli, Paolo; Guaraldi, G.; Spinillo, A.; Vimercati, A.; Maso, G.; Pinnetti, C.; Frisina, V.; Dalzero, S.; Ravizza, M.; Di Lorenzo, F.; Sterrantino, G.; Meli, M.; Campolmi, I.; Vichi, F.; Del Pin, B.; Marocco, R.; Mastroianni, C.; Mercurio, V. S.; Maccabruni, A.; Zaramella, M.; Mariani, Bianca; Nardini, G.; Stentarelli, C.; Beghetto, B.; Antoni, A. M. Degli; Molinari, A.; Crisalli, M. P.; Donisi, A.; Piepoli, M.; Cerri, V.; Zuccotti, G.; Giacomet, V.; Coletto, S.; Di Nello, F.; Madia, C.; Placido, G.; Milini, P.; Savalli, F.; Portelli, V.; Sabbatini, F.; Francisci, D.; Angeli, G.; Bernini, L.; Grossi, P.; Rizzi, L.; Bernardon, M.; Rizzante, E.; Belcaro, C.; Meloni, Antonio; Dedoni, M.; Ortu, F.; Piano, Pierluigi; Citernesi, A.; Vicini, I. Bordoni; Luzi, K.; Roccio, M.; Miccolis, A.; De Gennaro, A.; Guerra, B.; Cervi, Filippo; Simonazzi, G.; Margarito, E.; Capretti, M. G.; Marsico, C.; Faldella, G.; Sansone, M.; Agangi, A.; Capone, A.; Maruotti, G. M.; Tibaldi, C.; Trentini, L.; Todros, T.; Brambilla, T.; Savasi, V.; Personeni, C.; Giaquinto, C.; Fiscon, M.; Rubino, E.; Franceschetti, L.; Tassis, B.; Genovese, O.; Cafforio, C.; Casadei, A. M.; Cavaliere, A. F.; Cellini, Matteo; Marconi, A. M.; Sacchi, V.; Ierardi, M.; Polizzi, C.; Mattei, A.; Pirillo, M. F.; Amici, R.; Galluzzo, C. M.; Donnini, S.; Baroncelli, S.; Cerioli, A.; DE MARTINO, MARIA CRISTINA; Parazzini, F.; Vella, S.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2072607
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