Inter-pregnancy interval and pregnancy outcomes among HIV positive mothers in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria

Abstract

Background: Both short and long inter-pregnancy intervals have been associated with higher risk of adverse pregnancy outcomes. More so, short interpregnancy interval among HIVpositive women implies higher birth rate and subsequently a higher number of neonates exposed to HIV and potentially at risk of mother-to-child transmission. Aims: To study the influence of inter-pregnancy interval on pregnancy outcomes among booked HIV-positive mothers with singleton live-births at Nauth, Nnewi. Methods: A cross-sectional study was carried out with the aid of structured questionnaires, maternal clinical records and relevant anthropometry, between May and December 2011, among booked multiparous HIV-positive mother/singleton newborn pairs at NAUTH, Nnewi. Results: More than half (56.5%) of the 175 multiparous HIVpositive women studied had short inter-pregnancy interval (<18 months). Short inter-pregnancy interval was signi ficantly associated with adverse maternal and perinatal outcomes like maternal anaemia (X2 =14.95, p=0.021) and low values of maternal orneonatal anthropometric parameter s. However only adverse maternal outcomes and MAC/OFC ratio of t h e n e o n a t e s r e ma i n e d significantly associated with short Inter-pregnancy interval after logistic regression analysis. Long inter-pregnancy interval was significantly associated with low values of neonatal anthropometric parameters and maternal MAC less than 25cm (X2=15.10, p=0.019) as well as third trimester weight gain rate less than 250g/week (X2 =31.20, p= 0.000). The proportion of mothers with long interpregnancy that had anaemia or intra-partum BMI less than 25kg/ m2 differed only slightly from that of those with inter-pregnancy interval of 18-59 months. Conclusion: Inter-pregnancy interval of 18 to 59 months is significantly associated with the lowest risk of both adverse maternal and fetal outcomes among HIV-positive women.