Evaluation of prematurity among HIV infected and non-infected women in Rio de Janeiro, Brazil
T.P. Costa1, M.D.C. Leal2, C. Jurema2, E. Machado3, R.H. Oliveira1, C.B. Hofer4
1Universidade Federal do Rio de Janeiro, Pediatrics, Rio de Janeiro, Brazil, 2Escola Nacional de Saúde Pública/FIOCRUZ, Epidemiology, Rio de Janeiro, Brazil, 3Universidade Federal do Rio de Janeiro, Infectious Diseases, Rio de Janeiro, Brazil, 4Universidade de Federal do Rio de Janeiro, Preventive Medicine - Infectious Diseases, Rio de Janeiro, Brazil
Background: HIV status of the pregnant women, treatments, and pregnancy outcomes. The
aim of this study is to evaluate intervening variables in the occurrence of
prematurity in pregnant women infected or not with HIV.
Methods: It is an unmatched case-control study (3 controls per
case). Cases were derived from a prospective cohort study of all HIV-infected
pregnant women followed from 1995 to 2005, in a reference center in Rio de Janeiro. Controls were derived from a
random sample of all pregnant women who gave birth at Rio de Janeiro Municipality
between 1999 and 2001.
All relevant socio-demographic, nosological, and pregnancy outcomes data were
retrieved from both cohort studies. To evaluate the prenatal care, we
calculated the Kotelchuck
modified index, it measures the concentration of prenatal visits during the
care period, according to gestational age at birth. Comparisons were performed using
Student t- and Chi-square test. Variables with p-value< 0.25 were included in
a logistic regression model.
Results: There were
713 cases and 2145 controls. Variables associated with prematurity, controlling
for cases and controls were less than 8 years of education (OR=1,35,
95%CI=1,07-1,70); hypertension (OR=1,54, 95%CI=1,06-2,26), more pregnancies
(OR=1,10, 95%, CI=1,02-1,19), and inadequate Kotelchuck modified
conclusion, education, - hypertension, more pregnancies, and inadequate number
of prenatal care visits were associated with prematurity, even adjusting for
HIV status. Although in Brazil,
the HIV care is free of charge, pregnant women are still reaching late the
specialized care, with consequently higher rates of prematurity. Better access
to care must be offered to this population, and studies of prematurity in the
HIV infected women must evaluate how late these women reach their care.
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