Organizing Committee: QAI 2025

Vollständiger Abstract

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<h4>Objective</h4>To identify independent risk modifiers of and develop a prediction model for preterm births for pregnant people living with HIV (PLWH).<h4>Methods</h4>We analyzed the British Columbia Perinatal HIV Surveillance Database for singleton births from January 1997 to December 2022. Risk modifiers for preterm birth (<37 weeks gestational age) were identified through univariate analyses. We then completed a multivariate logistic regression using clinically relevant risk factors and risk modifiers with P < 0.1 in the univariate analysis. Using stepwise regression with the Akaike information criterion, the prediction model was developed.<h4>Results</h4>Of 578 singleton pregnancies in pregnant PLWH, 111 (19.2%) had preterm births. After adjusting for history of preterm births, CD4 count at delivery, and antiretroviral regimens, independent risk factors include substance use in pregnancy (odds ratio [OR]: 1.9; 95% CI: 1.03 to 3.50; and P = 0.041), hepatitis C in pregnancy (OR: 1.98; 95% CI: 1.02 to 3.83; and P = 0.043), unsuppressed viral load at delivery (OR: 2.03; 95% CI: 1.09 to 3.79; and P = 0.026), and sexually transmitted infections or bacterial vaginosis (STIBV) in pregnancy (OR: 2.06; 95% CI: 1.04 to 4.10; and P = 0.039). A prediction model with substance use, STIBV, hepatitis C in pregnancy, unsuppressed viral load, and low CD4 count was developed Area Under the Curve (AUC) = 0.73). For PLWH without any risk factors, the predicted probability of preterm birth is 9%.<h4>Conclusions</h4>Independent risk factors associated with preterm births in pregnant PLWH include substance use in pregnancy, unsuppressed viral load, hepatitis C co-infection, and STIBV in pregnancy. Our simplified preterm birth prediction tool provides a personalized approach to caring for pregnant PLWH.

Abstract: PubMed · Datensatz