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Prevalence, risk factors, and pregnancy outcomes of cervical cell abnormalities in the puerperium in a hyperendemic HIV setting.

Prevalence, risk factors, and pregnancy outcomes of cervical cell abnormalities in the puerperium in a hyperendemic HIV setting.
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Maise HC, Moodley D, Sebitloane M, Maman S, Sartorius B,


Maise HC, Moodley D, Sebitloane M, Maman S, Sartorius B, (click to view)

Maise HC, Moodley D, Sebitloane M, Maman S, Sartorius B,

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International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2017 09 28() doi 10.1002/ijgo.12330

Abstract
OBJECTIVE
To investigate the impact of cervical cell abnormalities detected in the puerperium in association with HIV-1 infection on pregnancy outcomes.

METHODS
The present study was a secondary data analysis of pregnancy outcomes, Pap smear results, HIV results, and participant demography from a behavioral intervention randomized controlled trial of 1480 pregnant women aged 18 years or more conducted at a periurban primary health clinic in South Africa during 2008-2010. The Pap smear was performed 14 weeks after delivery.

RESULTS
In total, 564 (38.1%) women were HIV-1-positive and 78 (8.0%) of 973 women with a categorized Pap smear result tested positive for cervical cell abnormalities; 42 (4.2%) women had low-grade squamous intraepithelial lesions (LGSILs) and 7 (0.7%) had high-grade lesions (HGSILs). In an adjusted analysis, HIV infection was significantly more common among women with LGSILs (28/42 [66.7%]) or HGSILs (6/7 [85.7%]) when compared with the other Pap smear categories (P<0.001). The rates of premature birth, low birth weight, and non-live births were similar among HIV-infected and -uninfected women with abnormal cervical cytology. CONCLUSION
Pregnant women with HIV were more likely to be diagnosed with higher grades of squamous cell abnormalities than those without HIV. There was no association between squamous cell abnormalities/HIV comorbidity and adverse pregnancy outcomes. This article is protected by copyright. All rights reserved.

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