Research Published on Outcomes of HIV-Positive Pregnancies

Pregnant woman holding her belly in black outfit

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