Lapat Jolly Joe, Opee Jimmyy, Okello James, Oyoo Nixson, Wanican Christopher, Labong Gloria Becky, Ebbs Daniel S, Bongomin Felix
Department of Public Health, Faculty of Medicine, Gulu, Uganda.
Anaka General Hospital, Nwoya District Local Government, Gulu, Uganda.
PLoS One. 2025 Jun 17;20(6):e0326322. doi: 10.1371/journal.pone.0326322. eCollection 2025.
Women of reproductive age constitute a significant proportion of the global HIV burden, with millions becoming pregnant while on lifelong antiretroviral therapy (ART). Although ART has dramatically improved maternal and child health outcomes, concerns persist regarding its safety in pregnancy. This study compares obstetric and neonatal outcomes between women with and without HIV infection at Anaka General Hospital, a rural hospital in northern Uganda.
A hospital-based retrospective cross-sectional study at Anaka General Hospital in northern Uganda was conducted from July 2020 to June 2023. A total of 914 delivery records were included, sampled using systematic random sampling from the hospital maternity register. Data were extracted from maternity and neonatal records using a structured tool. Associations between HIV status and obstetric or neonatal outcomes were assessed using Chi-square or Fisher's exact tests for categorical variables and independent sample t-tests for continuous variables. Multivariable logistic regression was used to adjust for potential confounders and a p < 0.05 was considered statistically significant.
Of the 914 participants included in the study 38 (4.2%) were HIV-positive. The odds of congenital anomalies were significantly higher among infants born to HIV-positive women compared with HIV-negative women (adjusted odds ratio = 9.76, 95% confidence interval: 1.72-55.48, p < 0.01). No significant differences were observed in maternal or neonatal outcomes between the two groups.
HIV infection was significantly associated with an increased risk of congenital anomalies, while other obstetric and neonatal outcomes were similar between HIV-positive and HIV-negative women. We recommend enhanced prenatal monitoring and early fetal screening among HIV-positive pregnant women on dolutegravir-based ART. Additionally, prospective studies are needed to better understand the contribution of dolutegravir and maternal factors to congenital anomalies in HIV-exposed pregnancies.
育龄女性在全球艾滋病毒负担中占很大比例，数百万女性在接受终身抗逆转录病毒治疗（ART）期间怀孕。尽管抗逆转录病毒疗法显著改善了母婴健康结局，但人们对其在孕期的安全性仍存在担忧。本研究比较了乌干达北部一家农村医院——阿纳卡综合医院感染艾滋病毒和未感染艾滋病毒的女性的产科和新生儿结局。
2020年7月至2023年6月在乌干达北部的阿纳卡综合医院开展了一项基于医院的回顾性横断面研究。共纳入914份分娩记录，采用系统随机抽样从医院产科登记册中抽取样本。使用结构化工具从产科和新生儿记录中提取数据。对于分类变量，采用卡方检验或费舍尔精确检验评估艾滋病毒感染状况与产科或新生儿结局之间的关联；对于连续变量，采用独立样本t检验。使用多变量逻辑回归调整潜在混杂因素，p<0.05被认为具有统计学意义。
在纳入研究的914名参与者中，38名（4.2%）为艾滋病毒阳性。与艾滋病毒阴性女性相比，艾滋病毒阳性女性所生婴儿出现先天性异常的几率显著更高（调整后的优势比=9.76，95%置信区间：1.72-55.48，p<0.01）。两组之间在孕产妇或新生儿结局方面未观察到显著差异。
艾滋病毒感染与先天性异常风险增加显著相关，而艾滋病毒阳性和阴性女性之间的其他产科和新生儿结局相似。我们建议对接受基于多替拉韦的抗逆转录病毒治疗的艾滋病毒阳性孕妇加强产前监测和早期胎儿筛查。此外，需要开展前瞻性研究，以更好地了解多替拉韦和母体因素对暴露于艾滋病毒的妊娠中先天性异常的影响。
