HIV-TB coinfection tied to higher risk for obstetric complications

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Takeaway

  • HIV-TB coinfections in pregnant women increase risk for substance abuse, pregnancy complications, and emotional/mental health issues, and create a pathway toward significant morbidity/mortality.

Why this matters

  • As HIV-TB coinfection increases the risk for pregnancy complications, likelihood increases for alcohol/drug abuse; tailored education, reinforcement of condition, and links with community assets are recommended.

Key results

  • 57,939,459 deliveries; TB rate among HIV+ mothers was 150.23/100,000 (~21 times higher than TB rate in entire population of pregnant women).
  • HIV-TB coinfected mothers had greatest risk for pregnancy complications (ie, eclampsia, placental accreta, and anemia), even after adjustments for alcohol use, drug abuse, and depression (OR, 2.00; 95% CI, 0.83-4.79).
  • Likelihood of alcohol use was also higher in HIV-TB coinfection (OR, 11.39; 95% CI, 1.38-94.06) vs HIV+ (OR, 5.12; 95% CI, 4.42-5.93) or TB (OR, 2.10; 95% CI, 0.79-5.55) monoinfection.
  • Risks for drug abuse (OR, 5.08; 95% CI, 1.43-18.04) and depression (OR, 2.55; 95% CI, 0.34-19.09) were also elevated.

Study design

  • Retrospective study of discharge data for ~57 million pregnant women in the US during 2002-2014.
  • Funding: US Department of Health and Human Services.

Limitations

  • Care quality, HIV protocol adherence data missing.
  • Absence of biological predictive markers for pregnancy complications or substance abuse or depression.