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dc.contributor.authorSouda, Sajini
dc.contributor.authorParekh, Natasha
dc.contributor.authorBinda, Kelebogile
dc.contributor.authorKayembe, Mukendi
dc.contributor.authorSvab, Petr
dc.contributor.authorBabitseng, Orphinah
dc.contributor.authorJimbo, William
dc.contributor.authorCreek, Tracy
dc.contributor.authorEssex, Max
dc.contributor.authorShapiro, Roger L.
dc.contributor.authorLockman, Shahin
dc.contributor.authorPowis, Kathleen Marie
dc.contributor.authorMakhema, Joseph Moeketsi
dc.contributor.authorRoberts, Drucilla Jane
dc.date.accessioned2013-02-20T19:06:10Z
dc.date.issued2012
dc.identifier.citationShapiro Roger L., Sajini Souda, Natasha Parekh, Kelebogile Binda, Mukendi Kayembe, Shahin Lockman, Petr Svab, et al. (2012) High prevalence of hypertension and placental insufficiency, but no in utero HIV transmission, among women on HAART with stillbirths in Botswana. PLoS ONE 7(2): e31580.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10318213
dc.description.abstractBackground: Increased stillbirth rates occur among HIV-infected women, but no studies have evaluated the pathological basis for this increase, or whether highly active antiretroviral therapy (HAART) influences the etiology of stillbirths. It is also unknown whether HIV infection of the fetus is associated with stillbirth. Methods: HIV-infected women and a comparator group of HIV-uninfected women who delivered stillbirths were enrolled at the largest referral hospital in Botswana between January and November 2010. Obstetrical records, including antiretroviral use in pregnancy, were extracted at enrollment. Verbal autopsies; maternal HIV, CD4 and HIV RNA testing; stillbirth HIV PCR testing; and placental pathology (blinded to HIV and treatment status) were performed. Results: Ninety-nine stillbirths were evaluated, including 62 from HIV-infected women (34% on HAART from conception, 8% on HAART started in pregnancy, 23% on zidovudine started in pregnancy, and 35% on no antiretrovirals) and 37 from a comparator group of HIV-uninfected women. Only 2 (3.7%) of 53 tested stillbirths from HIV-infected women were HIV PCR positive, and both were born to women not receiving HAART. Placental insufficiency associated with hypertension accounted for most stillbirths. Placental findings consistent with chronic hypertension were common among HIV-infected women who received HAART and among HIV-uninfected women (65% vs. 54%, p = 0.37), but less common among HIV-infected women not receiving HAART (28%, p = 0.003 vs. women on HAART). Conclusions: In utero HIV infection was rarely associated with stillbirths, and did not occur among women receiving HAART. Hypertension and placental insufficiency were associated with most stillbirths in this tertiary care setting.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0031580en_US
dash.licenseLAA
dc.titleHigh Prevalence of Hypertension and Placental Insufficiency, but No In Utero HIV Transmission, among Women on HAART with Stillbirths in Botswanaen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorShapiro, Roger L.
dc.date.available2013-02-20T19:06:10Z
dc.identifier.doi10.1371/journal.pone.0031580*
dash.authorsorderedfalse
dash.contributor.affiliatedRoberts, Drucilla
dash.contributor.affiliatedPowis, Kathleen
dash.contributor.affiliatedMakhema, Joseph
dash.contributor.affiliatedLockman, Shahin
dash.contributor.affiliatedShapiro, Roger


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