Objectives: To study the impact of HIV-1 infection on pregnancy and maternal and early fetal outcome.
Method: From January 1992 to January 1993, 160 HIV-1 seropositive women and 164 HIV-1 seronegative age- and parity-matched pregnant tribal women from Manipur, India, were recruited into a prospective study. Mother and infant were followed until 6 weeks postpartum.
Results: Nine percent (15/160) of subjects had AIDS (CDC IV), 38% (60/160) were symptomatic (CDC III) and 53% (85/160) were asymptomatic (CDC I/II). Symptomatic (CDC III/IV) HIV-1 infection is associated with a significantly increased rate of miscarriage, low birth weight, intrauterine fetal death and preterm delivery. Perinatal, infant and maternal deaths were limited to symptomatic women. HIV-1 infected women were significantly younger than their HIV-1 negative counterparts both in age and age at sexual debut. Placental membrane inflammation was significantly higher in the seropositive group and this correlated well with a higher risk of preterm delivery and postpartum endometritis. Asymptomatic HIV-1 infection was not associated with adverse pregnancy outcome.
Conclusion: Symptomatic (CDC III/IV) HIV-1 infection in Indian tribal women is associated with adverse maternal and fetal outcome.