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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

GLOBAL: One-in-Four Deaths in Pregnancy Due to HIV in Worst-Affected Countries


AIDSMAP (04.09.13)

Researchers from the London School of Hygiene and Tropical Medicine report that the risk of pregnancy-related death is eight times higher for HIV-infected women than for uninfected women. In sub-Saharan countries with high HIV prevalence, one in four pregnancy-related deaths can be attributed to HIV. The study authors based their conclusions on a systematic review of 23 studies that had collected data on the risk of pregnancy-related death among uninfected and HIV-infected women. Many of the 23 studies were conducted in areas of the world where a “verbal autopsy” from family members is the most common form of death report. Most of the HIV-infected women in the 23 studies were not taking antiretroviral therapy and were in an “advanced stage” of the disease. Little is known about the effects of HIV on pregnancy; it is not clear whether HIV causes more complications for pregnant women or whether pregnancy triggers the HIV progression. The review compared death during pregnancy and the postpartum period among HIV-infected women and uninfected women to calculate the relative risk of death and the prevalence of HIV, and then used the pooled relative risk data from the meta-analysis to predict the effect of HIV on pregnancy-related death at the population level. This calculation method removes assumptions about HIV being related to or coincidental to pregnancy. Severe anemia and TB can cause maternal death and HIV-related death indirectly. Study authors suggest that future studies focus on identifying HIV-related deaths from “verbal autopsies.” Previous estimates of pregnancy-related death among HIV-infected women were not based on empirical data and did not distinguish between pregnancy-related deaths and maternal death that was incidental to the pregnancy. The full report, “The Contribution of HIV to Pregnancy-Related Mortality: A Systematic Review and Meta-analysis,” was published online in the journal AIDS (2013; doi: 10.1097/qad.0b013e32835fd940).


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Information in this article was accurate in April 10, 2013. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.