The Impact of Antiretroviral Therapy on Birth Outcomes: A Retrospective Cohort Study

Objective: This study aimed to evaluate the impact of highly active antiretroviral therapy (HAART) on pregnancy outcomes at a major tertiary hospital in Abuja, Nigeria. Design: A cohort study was conducted. Methods: HIV-infected pregnant women who initiated HAART during pregnancy for the prevention of mother-to-child transmission (pMTCT) were recruited, alongside a randomly selected group of HIV-uninfected pregnant women. Results: A total of 489 pregnant women participated, including 237 HIV-infected and 252 HIV-uninfected women. HAART initiation during pregnancy was significantly associated with higher mean birth weights (p = 0.0007). While there were 30 cases of low birth weight in the HIV-infected group compared to 21 in the HIV-uninfected group, HAART was not significantly associated with low birth weight (OR 1.59, p = 0.1182). There were 6 stillbirths in the HIV-infected group and 5 in the uninfected group, with no significant association between HIV status and stillbirth (OR 1.28, p = 0.6836). However, 29 preterm deliveries occurred in the HIV-infected group compared to 8 in the uninfected group, showing a strong association between HIV infection and preterm deliveries despite HAART initiation (OR 4.25, p = 0.0002). Conclusion: HIV-infected women receiving HAART during pregnancy have a significantly reduced risk of low birth weight but face an increased risk of preterm delivery.