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

Raziano, Valerie Teresa (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/b5644s50h?locale=en
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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.

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