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

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dc.contributor.authorFatti, Geoffrey
dc.contributor.authorShaikh, Najma
dc.contributor.authorEley, Brian
dc.contributor.authorJackson, Debra
dc.contributor.authorGrimwood, Ashraf
dc.date.accessioned2021-10-08T07:20:27Z
dc.date.available2021-10-08T07:20:27Z
dc.date.issued2014
dc.description.abstractBACKGROUND: South Africa (SA) has the highest burden of childhood HIV infection globally, and has high rates of adolescent and youth pregnancy OBJECTIVE: To explore risks associated with pregnancy in young HIV-infected women, we compared mother-to-child transmission (MTCT) of HIV and maternal and infant health outcomes according to maternal age categories METHODS: A cohort of HIV-positive pregnant women and their infants were followed up at three sentinel surveillance facilities in the Nelson Mandela Bay Metropolitan (NMBM) district, Eastern Cape Province, SA. Young women were defined as 24 years as the comparison group RESULTS: Of 956 mothers, 312 (32.6%) were young women; of these, 65 (20.8%) were adolescents. The proportion of young pregnant women increased by 24% between 2009/10 and 2011/12 (from 28.3% to 35.1%). Young women had an increased risk of being unaware of their HIV status when booking (adjusted risk ratio (aRR) 1.37; 95% confidence interval (CI) 1.21 - 1.54), a reduced rate of antenatal antiretroviral therapy (ART) uptake (adjusted hazard ratio 0.46; 95% CI 0.31 - 0.67), reduced early infant HIV diagnosis (aRR 0.94; 95% CI 0.94 - 0.94), and increased MTCT (aRR 3.07; 95% CI 1.18 - 7.96; adjusted for ART use). Of all vertical transmissions, 56% occurred among young women. Additionally, adolescents had increased risks of first presentation during labour (aRR 3.78; 95% CI 1.06 - 13.4); maternal mortality (aRR 35.1; 95% CI 2.89 - 426) and stillbirth (aRR 3.33; 95% CI 1.53 - 7.25 CONCLUSION: An increasing proportion of pregnant HIV-positive women in NMBM were young, and they had increased MTCT and poorer maternal and infant outcomes than older women. Interventions targeting young women are increasingly needed to reduce pregnancy, HIV infection and MTCT and improve maternal and infant outcomes if SA is to attain its Millennium Development Goals
dc.identifier.apacitationFatti, G., Shaikh, N., Eley, B., Jackson, D., & Grimwood, A. (2014). 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. <i>South African Medical Journal</i>, 104(12), 874 - 177. http://hdl.handle.net/11427/34917en_ZA
dc.identifier.chicagocitationFatti, Geoffrey, Najma Shaikh, Brian Eley, Debra Jackson, and Ashraf Grimwood "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." <i>South African Medical Journal</i> 104, 12. (2014): 874 - 177. http://hdl.handle.net/11427/34917en_ZA
dc.identifier.citationFatti, G., Shaikh, N., Eley, B., Jackson, D. & Grimwood, A. 2014. 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. <i>South African Medical Journal.</i> 104(12):874 - 177. http://hdl.handle.net/11427/34917en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Fatti, Geoffrey AU - Shaikh, Najma AU - Eley, Brian AU - Jackson, Debra AU - Grimwood, Ashraf AB - BACKGROUND: South Africa (SA) has the highest burden of childhood HIV infection globally, and has high rates of adolescent and youth pregnancy OBJECTIVE: To explore risks associated with pregnancy in young HIV-infected women, we compared mother-to-child transmission (MTCT) of HIV and maternal and infant health outcomes according to maternal age categories METHODS: A cohort of HIV-positive pregnant women and their infants were followed up at three sentinel surveillance facilities in the Nelson Mandela Bay Metropolitan (NMBM) district, Eastern Cape Province, SA. Young women were defined as 24 years as the comparison group RESULTS: Of 956 mothers, 312 (32.6%) were young women; of these, 65 (20.8%) were adolescents. The proportion of young pregnant women increased by 24% between 2009/10 and 2011/12 (from 28.3% to 35.1%). Young women had an increased risk of being unaware of their HIV status when booking (adjusted risk ratio (aRR) 1.37; 95% confidence interval (CI) 1.21 - 1.54), a reduced rate of antenatal antiretroviral therapy (ART) uptake (adjusted hazard ratio 0.46; 95% CI 0.31 - 0.67), reduced early infant HIV diagnosis (aRR 0.94; 95% CI 0.94 - 0.94), and increased MTCT (aRR 3.07; 95% CI 1.18 - 7.96; adjusted for ART use). Of all vertical transmissions, 56% occurred among young women. Additionally, adolescents had increased risks of first presentation during labour (aRR 3.78; 95% CI 1.06 - 13.4); maternal mortality (aRR 35.1; 95% CI 2.89 - 426) and stillbirth (aRR 3.33; 95% CI 1.53 - 7.25 CONCLUSION: An increasing proportion of pregnant HIV-positive women in NMBM were young, and they had increased MTCT and poorer maternal and infant outcomes than older women. Interventions targeting young women are increasingly needed to reduce pregnancy, HIV infection and MTCT and improve maternal and infant outcomes if SA is to attain its Millennium Development Goals DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 12 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/34917 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34917
dc.identifier.vancouvercitationFatti G, Shaikh N, Eley B, Jackson D, Grimwood A. 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. South African Medical Journal. 2014;104(12):874 - 177. http://hdl.handle.net/11427/34917.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue12
dc.source.journalvolume104
dc.source.pagination874 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.8207
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherAge Factors
dc.subject.otherAnti-HIV Agents
dc.subject.otherCohort Studies
dc.subject.otherFemale
dc.subject.otherHIV Infections
dc.subject.otherHumans
dc.subject.otherInfant, Newborn
dc.subject.otherInfectious Disease Transmission, Vertical
dc.subject.otherPregnancy
dc.subject.otherPregnancy Complications, Infectious
dc.subject.otherPregnancy Outcome
dc.subject.otherRisk
dc.subject.otherSouth Africa
dc.subject.otherYoung Adult
dc.titleAdolescent 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
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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