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Researchers from MedStar Health Research Institute (MHRI), MedStar Washington Hospital Center (MWHC) and National Institute of Health (NIH) have recently sought to identify outcomes for HIV-positive women during pregnancy.
“Delivery After 40 Weeks of Gestation in Pregnant Women With Well-Controlled Human Immunodeficiency Virus” was published in Obstetrics & Gynecology. This research was led by Rachel K. Scott, MD, MPH, scientific director of women’s health research at MHRI and obstetrician/gynecologist and director of the Women’s Center for Positive Living at MWHC. The research team included Nahida Chakhtoura, MD; Margaret M. Burke, MD; Rachel A. Cohen, MS; and Regis Kreitchmann, MD.
This secondary analysis identified pregnant women with HIV-1, comparing delivery outcomes at 38-40 weeks estimated gestational age with outcomes of women who delivered at 40-42 weeks estimated gestational age. This research was conducted to fill a gap in formal guidelines for timing of delivery in well-controlled HIV-positive pregnancies. The researchers found that in pregnant women with well-controlled HIV-1, “the risk of mother-to-child transmission did not differ significantly by estimated gestational age at delivery.” The data suggest that pregnant women with viral loads of 1,000 copies/mL or less can be safely delivered per current obstetric indications.
Dr. Scott also presented two related studies at the International AIDS Society scientific meeting. These abstracts are the result of a DC-Center for AIDS research pilot award to investigate maternal and neonatal pregnancy outcomes of pregnancies complicated by HIV. In these studies, “Neonatal Outcomes of Pregnancies Complicated by HIV: Preliminary Results of a Retrospective Matched Cohort Study from 2004 to 2014” and “Pregnancy Outcomes of Women Living with HIV: Preliminary Results of a Retrospective Matched Cohort Study from 2004 to 2014,” Dr. Scott shared preliminary results from the soon-to-be completed retrospective matched cohort study of pregnancy outcomes at MWHC. This cohort of HIV-positive pregnancies is the largest single-site matched cohort in the United States.The preliminary findings have demonstrated increased maternal psychosocial and behavioral morbidity and increased proportions of complications for HIV-exposed neonates.
Obstetrics & Gynecology, 2017. DOI: 10.1097/AOG.0000000000002186