Birth outcomes in perinatally HIV-infected adolescents and young adults in Manipur, India: A new frontier

Objective: The objective was to study birth outcomes in perinatally HIV infected adolescents and young adults. Method: Between January 1997 and January 2001, 30 asymptomatic perinatally HIV-infected primigravid pregnancies (Group A, study group) were identified amongst perinatally HIV-infected adolescents and young adults. They were attending the high-risk antenatal clinic at the Government Hospital, Manipur. Pregnancy and birth outcome were assessed. The control group (Group B) consisted of 28 perinatally infected females with no history of pregnancy. Both groups, of tribal origin, were matched for age ≤1 of the age of the pregnant females: median age 18 years (range: 16-22 years) and socio-economic class, (lower middle socio-economic class). Results: The median viral load of the pregnant women were 16,383 copies/ml (range 5,251-65,571 copies/ml) and median CD4 count was 220 cells/mm3 (range: 18-980 cells/mm3. Twenty-seven (90%) of the 30 pregnant women received antiretroviral therapy (ARV) consistently during the pregnancy. Among the 30 pregnancies, 4 ended in elective abortion. The remaining 26 women delivered 26 live born infants (of these, one was a preterm delivery (35.2 weeks). There was no IUFD, IUGR, spontaneous miscarriages, or fetal, infant or maternal deaths. Conclusion: Pregnancy in perinatally HIV-infected adolescents and young adults, does not appear to be associated with adverse maternal or fetal outcome if retroviral therapy is taken consistently prior and during the pregnancy. Counseling with respect to sexual activities, pregnancy and birth control is mandatory. © Springer-Verlag 2003.