A retrospective study on adverse obstetric outcomes in HIV-infected pregnancy in West Bengal, India

Introduction
Human immunodeficiency virus (HIV) does not change the course of pregnancy, but seems to exert adverse obstetric outcomes like low birth weight, spontaneous abortion, or stillbirth. Antiretroviral treatment seems to reduce the chance of adverse outcomes. Frequently, HIV-infected women also seems to opt for medical termination of pregnancy (MTP). This study is to compare adverse obstetric outcomes and MTP rate for HIV-infected pregnancy with that in the general population irrespective of antiretroviral treatment (ART).

Material and methods
A retrospective cohort study was carried out through analysis of secondary data from 314 integrated counselling and testing centers across the state of West Bengal from October 2016 to December 2017. A total number of 227 HIV-infected on ART pregnancies, whose obstetric outcomes happened during the study period were followed up, and rate for low birth weight, spontaneous abortion, stillbirth, and MTP were calculated, and it was compared with still birth rate of the state among all pregnancies as per data of the District Level Household Survey 4 from 2013.

Results
Rates for low birth weight (28.04 per 100 pregnancy outcomes), spontaneous abortion (4.85 per 100), stillbirth (2.64 per 100), and MTP (9.25 per 100 live birth) were found to be significantly high for HIV-infected pregnancies on ART, as compared to the general population. MTP rates and low birth weight rates for general pregnancies did not fall within the 95% confidence interval of those rates for HIV-infected pregnancies.

Conclusion
HIV infection was responsible for significant adverse obstetric outcome irrespective of antiretroviral treatment.