Factors Correlated with Self-Reported History of Fetal Death amongUrban, HIV-positive US Women Open Access

Abstract

Background . Fetal death (broadly classified as stillbirths and miscarriages) among United States women are currently understudied and underreported. Data on fetal death among HIV positive women are especially limited.

Methods. A cross-sectional analysis of data collected at an urban outpatient HIV care clinic in Atlanta, Georgia between July 2003-November 2004 evaluated factors correlated with self-reported history of miscarriage or stillbirth among HV positive women. Crude and adjusted prevalence odds ratios (PORs) and 95% confidence intervals (CIs) from logistic regression models are reported.

Results . Of the 155 women in this analysis 89% of whom were African American, 56 (36%) reported history of fetal death. Factors correlated (p<0.1) with history of fetal death included older age (aPOR = 1.09; 95%CI: 1.02-1.18), older age at first vaginal sex (aPOR = 0.84; 95%CI: 0.73-0.96), history of physical abuse (aPOR = 2.00; 95%CI: 0.87-4.59), and being on HIV medications two years or more (protective, aPOR = 0.16; 95%CI: 0.05-0.46), controlling for age of HIV+ diagnosis and lifetime history of multiple sexually transmitted diseases.

Conclusions. Though it is difficult to draw conclusions given the cross-sectional nature of the data, this study found a very high prevalence of fetal death among HIV positive women as well as correlates that warrant further investigation. In particular, whether time on ART in HIV+ women is actually protective for fetal death warrants exploration. Physical abuse has been associated with fetal death in general cross-sectional populations, and this study now indicates this association for HIV positive women.

Table of Contents

Introduction 1-4

Methods 4-6

Results 6-8

Discussion 9-11

Conclusions 11

References 12-15

Tables 16-24

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology Health Sciences, Obstetrics and Gynecology
Keyword	HIV-positive Women Stillbirth Miscarriage United States
Committee Chair / Thesis Advisor	Wall, Kristin, Emory University
Committee Members	Haddad, Lisa, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs Hospital or other health care provider

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