Prognosis

AIDS-related mortality has declined by 56% among women and girls since 2010.[2]

The disease status of women with human immunodeficiency virus (HIV) infection in pregnancy does not differ significantly from the prognosis for women with HIV outside of pregnancy. Pregnancies complicated by HIV are more complicated than their HIV-negative counterparts, however. Women with HIV have persistently higher rates of obstetric and postpartum morbidity such as elevated rates of cesarean delivery, preterm premature rupture of membranes, spontaneous preterm delivery, endometritis, and intensive care unit admission.[10][11][12][13]​ Post-cesarean complications have decreased dramatically in the US from 210.6/1000 from 1995 to 1996 to 116.6/1000 in 2010 to 2011; however, rates of infection, surgical trauma, hospital deaths, and prolonged hospitalization remain significantly higher than in HIV-uninfected women.[14] In addition, multiple studies suggest that neonates born to women with HIV are at increased risk for complications such as prematurity and being small for gestational age, among others.[7][11]

With physical recovery after delivery, the stresses and demands of caring for a new baby, and the risk of postpartum depression, mothers with HIV are particularly vulnerable to problems with adherence to antiretroviral therapy. Support and attention to this issue is warranted.

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