TY - JOUR
T1 - Incidence of childbirth, pregnancy, spontaneous abortion, and induced abortion among women with Human Immunodeficiency Virus (HIV), a nationwide matched cohort study
AU - Paulsen, Fie W
AU - Tetens, Malte M
AU - Vollmond, Cecilie V
AU - Gerstoft, Jan
AU - Kronborg, Gitte
AU - Johansen, Isik S
AU - Larsen, Carsten S
AU - Wiese, Lothar
AU - Dalager-Pedersen, Michael
AU - Lunding, Suzanne
AU - Nielsen, Lars N
AU - Weis, Nina
AU - Obel, Niels
AU - Omland, Lars H
AU - Lebech, Anne-Mette
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2023/1/31
Y1 - 2023/1/31
N2 - BACKGROUND: Reproductive health in women with HIV (WWH) has improved in recent decades. We aimed to investigate incidences of childbirth, pregnancy, spontaneous abortion, and induced abortion among WWH in a nationwide, population-based, matched cohort study.METHODS: We included all WWH aged 20 to 40 treated at an HIV healthcare centre in Denmark from 1995-2021, and a matched comparison cohort of women from the general population (WGP). We calculated incidence rates per 1,000 person years and used Poisson regression to calculate adjusted incidence rate ratios (aIRR) of childbirth, pregnancy, spontaneous abortion, and induced abortion stratified according to calendar periods (1995-2001, 2002-2008, and 2009-2021).RESULTS: We included 1,288 WWH and 12,880 WGP. 46% of WWH were of African origin whereas 1% of WGP were of African origin. Compared to WGP, WWH had a decreased incidence of childbirth (aIRR: 0.6, 95% CI: 0.6-0.7), no difference in incidence of pregnancy (aIRR: 0.9, 95% CI: 0.8-1.0) or spontaneous abortion (aIRR: 0.9, 95% CI: 0.8-1.0), but an increased incidence of induced abortion (aIRR: 1.9, 95% CI: 1.6-2.1) from 1995-2021. The aIRR of childbirth, pregnancy, and spontaneous abortion increased from 1995-2000 to 2009-2021, while the aIRR of induced abortion remained increased across all time-periods for WWH.CONCLUSION: From 1995-2008, incidences of childbirth, pregnancy, and spontaneous abortion were decreased among WWH compared to WGP. From 2009-2021, the incidence of childbirth, pregnancy, and spontaneous abortion no longer differed among WWH compared with WGP. The incidence of induced abortions remains increased among WWH.
AB - BACKGROUND: Reproductive health in women with HIV (WWH) has improved in recent decades. We aimed to investigate incidences of childbirth, pregnancy, spontaneous abortion, and induced abortion among WWH in a nationwide, population-based, matched cohort study.METHODS: We included all WWH aged 20 to 40 treated at an HIV healthcare centre in Denmark from 1995-2021, and a matched comparison cohort of women from the general population (WGP). We calculated incidence rates per 1,000 person years and used Poisson regression to calculate adjusted incidence rate ratios (aIRR) of childbirth, pregnancy, spontaneous abortion, and induced abortion stratified according to calendar periods (1995-2001, 2002-2008, and 2009-2021).RESULTS: We included 1,288 WWH and 12,880 WGP. 46% of WWH were of African origin whereas 1% of WGP were of African origin. Compared to WGP, WWH had a decreased incidence of childbirth (aIRR: 0.6, 95% CI: 0.6-0.7), no difference in incidence of pregnancy (aIRR: 0.9, 95% CI: 0.8-1.0) or spontaneous abortion (aIRR: 0.9, 95% CI: 0.8-1.0), but an increased incidence of induced abortion (aIRR: 1.9, 95% CI: 1.6-2.1) from 1995-2021. The aIRR of childbirth, pregnancy, and spontaneous abortion increased from 1995-2000 to 2009-2021, while the aIRR of induced abortion remained increased across all time-periods for WWH.CONCLUSION: From 1995-2008, incidences of childbirth, pregnancy, and spontaneous abortion were decreased among WWH compared to WGP. From 2009-2021, the incidence of childbirth, pregnancy, and spontaneous abortion no longer differed among WWH compared with WGP. The incidence of induced abortions remains increased among WWH.
KW - women with HIV
KW - childbirth
KW - pregnancy
KW - spontaneous abortion
KW - induced abortion
U2 - 10.1093/cid/ciad053
DO - 10.1093/cid/ciad053
M3 - Journal article
C2 - 36718956
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
ER -