Adolescent and young pregnant women at increased risk of mother-to-child transmission of HIV and poorer maternal and infant health outcomes: A cohort study at public facilities in the Nelson Mandela Bay Metropolitan district, Eastern Cape, South Africa

• DOI: 10.7196/samj.8207
• Publication Date: 2014-12-02T09:02:17Z
• Authors: Geoffrey Fatti; Najma Shaikh; Brian Eley; Debra Jackson; Ashraf Grimwood
• Keywords: Adult; Risk; Adolescent; Anti-HIV Agents; Age Factors; Infant, Newborn; Pregnancy Outcome; 1. No poverty; HIV Infections; Infectious Disease Transmission, Vertical; 3. Good health; Cohort Studies; South Africa; Young Adult; 03 medical and health sciences; 0302 clinical medicine; 5. Gender equality; Pregnancy; Humans; Female; Pregnancy Complications, Infectious

Background. South Africa (SA) has the highest burden of childhood HIV infection globally, and high rates adolescent youth pregnancy. Objective. To explore risks associated with pregnancy in young HIV-infected women, we compared mother-to-child transmission (MTCT) maternal infant health outcomes according to age categories. Methods. A cohort HIV-positive pregnant women their infants were followed up at three sentinel surveillance facilities Nelson Mandela Bay Metropolitan (NMBM) district, Eastern Cape Province, SA. Young defined as ≤24 years old adolescents ≤19 years. The effect younger categories on MTCT child was assessed using log-binomial Cox regression controlling for confounding, aged >24 comparison group. Results. Of 956 mothers, 312 (32.6%) women; these, 65 (20.8%) adolescents. proportion increased by 24% between 2009/10 2011/12 (from 28.3% 35.1%). had an risk being unaware status when booking (adjusted ratio (aRR) 1.37; 95% confidence interval (CI) 1.21 - 1.54), a reduced rate antenatal antiretroviral therapy (ART) uptake hazard 0.46; CI 0.31 0.67), early diagnosis (aRR 0.94; 0.94 0.94), 3.07; 1.18 7.96; adjusted ART use). all vertical transmissions, 56% occurred among women. Additionally, first presentation during labour 3.78; 1.06 13.4); mortality 35.1; 2.89 426) stillbirth 3.33; 1.53 7.25). Conclusion. An increasing NMBM young, they poorer than older Interventions targeting are increasingly needed reduce pregnancy, improve if SA is attain its Millennium Development Goals.