Trends in preterm birth in women living with HIV in Switzerland over the last three decades: A multicentric, prospective, cohort study. Â Â HIV Medicine
Previous studies have shown that preterm birth is more common among pregnant women with HIV than among those without HIV. Several HIV-specific treatments may explain this: antiretroviral therapy can lead to early labor induction, past policies favored cesarean sections, increasing emergency interventions, and proactive delivery was advised for premature rupture of membranes.
However, most studies were conducted over ten years ago, and recommendations for the treatment of pregnant women with HIV have since changed. In the present study, Lumbreras Areta et al. assessed the rates of preterm birth among pregnant women with HIV in Switzerland between 1986 and 2020, compared them with the general population, and tried to identify factors and interventions associated with changes over time.
Of 1’238 singleton pregnancies born to 948 mothers, the rate of preterm birth was 20.4% prior to 2010, and progressively declined to 11.3% thereafter. However, these rates remain more than twice as high as in the general population. In multivariable analyses, higher CD4 cell counts and vaginal mode of delivery were associated with lower rates of preterm birth. The study did not find an association between antiretroviral drugs and preterm births.
In summary, although the rate of preterm birth decreased, pregnant women with HIV in Switzerland remain twice as likely to deliver preterm compared to women without HIV. The authors conclude that, given their findings, limiting cesarean sections to obstetric reasons and maintaining effective HIV control are necessary to close this gap.