Human immunodeficiency virus infection in advanced maternal age gravidas

Our study compares perinatal outcomes among HIV ⁺ versus HIV ^- advanced maternal aged (AMA) women. A retrospective cohort study of AMA deliveries from 2000 to 2009 was performed. HIV ⁺ (group A) women were compared to temporally matched HIV ^- (group B) women. Demographics, medical comorbidities, HIV treatment, and delivery data were collected. SAS was used for data analysis with p<0.05 considered significant. Seventy-one patients per study group were reviewed; for group A, the mean CD4 count near delivery was 507±363; 75% (34/45) had viral load ≤400 in the third trimester and 58% were on a protease inhibitor regimen. HIV ⁺ women had significantly higher preterm delivery (PTD) <37 weeks (A: 40.85%, B: 16.90%, p=0.0016). Logistic regression performed revealed that the odds of PTD was 2.83 (CI 1.22-6.54) for HIV ⁺ and 4.02 (CI 1.27-12.72) for drug use independent of other factors. The pathophysiology of PTD among HIV ⁺ AMA women warrants prospective examination to better define the causal relationship.