Pregnancy Outcomes in HIV-Infected Women: Our Experience at a Tertiary Health-Care Center, Ahmedabad, Western India

Background: HIV prevalence has been increasing among pregnant women in many regions within the country. Illiteracy, early marriage, violence and sexual abuse against women are the major socioeconomic reasons for their vulnerability to HIV infection. Estimating the HIV seroprevalence in a low risk population such as pregnant women provide essential information for monitoring trend of HIV in general population and assist in prevention from mother to child transmission.  Methods: This study is a retrospective computer based data analysis, conducted at Sheth V.S. General and Sheth C.M. Hospital, Smt. N.H.L Municipal Medical College, Ahmedabad, a tertiary health care center in Gujarat, India between January 2012 to December 2019. This study includes 68330 pregnant women who attended antenatal clinic or directly admitted in labor room in emergency. Blood sample collected after pretest counselling and informed consent, tested for HIV antibodies as per NACO guidelines. HIV sero-positive mothers and babies were managed at ART center of our institute according to latest guidelines of the same. Results: Out of 68330 pregnant women, 166 found to be HIV-positive with seroprevalence rate of 0.24%. Majority of seropositive women (49.4%) were in the age group of 25-30 Years. Out of 150 live births, 3 babies were found to be HIV sero-positive result at 18 months and were managed with ART according to latest NACO guidelines. Conclusions: Mother to child transmission of HIV infection during pregnancy, delivery or breast feeding is responsible for more than 90% of pediatrics AIDS. Proper antenatal screening, interventions and preventive strategies during pregnancy, delivery and breastfeeding will bring down the mother to child transmission of HIV. A multidisplinary team approach to management involving an HIV physician, experienced obstetrician, and neonatologist are essential to optimize maternal and fetal outcome