Infectious Disease

Birth rates similar among women with HIV and general population, induced abortions higher

March 15, 2023

2 min read

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Disclosures:
Paulsen reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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Key takeaways:

  • From 1995-2001, incidences of childbirth, pregnancy and spontaneous abortions were lower among women with HIV compared with those of women in the general population.
  • By 2009-2021, women with HIV saw similar incidences of childbirth and pregnancy, although there were increased rates of spontaneous abortion.

Rates of childbirth, pregnancy and spontaneous abortion decreased among women with HIV and reached incidences comparable to women in the general population, according to a study in Denmark. However, rates of induced abortion increased, researchers found.

“When women are diagnosed with HIV, one of their primary questions is, ‘Will I be able to have children?’ Because ART has become so effective, the focus has shifted away from mortality,” Fie W. Paulsen, BMSc, medical student in the department of infectious diseases at Copenhagen University Hospital, told Healio.

pregnant

Between 2009 and 2021, women with HIV had similar incidences of childbirth and pregnancy, although there were increased rates of spontaneous abortion, compared with women in the general population. Image: Adobe Stock.

“Further, we wanted to investigate whether there have been changes in reproductive health (ie, childbirth and abortion rates) among women with HIV since the general health [of women with HIV] has improved significantly,” Paulsen said.

Paulsen and colleagues performed a nationwide, matched population-based cohort study in Denmark to assess incidence rates of childbirth, pregnancy, spontaneous abortion and induced abortion among women with HIV (WWH) compared with a comparison cohort of women in the general population (WGP) .

According to the study, they calculated incidence rates per 1,000 person years, as well as adjusted incidence rate ratios (aIRRs) of childbirth, pregnancy, spontaneous abortion and induced abortion stratified according to calendar periods (1995-2001, 2002-2008 and 2009- 2021).

In total, 1,288 WWH and 12,880 WGP were included in the study. Overall, WWH had a decreased incidence of childbirth (aIRR = 0.6; 95% CI, 0.6-0.7) and no difference in incidence of pregnancy (aIRR = 0.9; 95% CI, 0.8-1) or spontaneous abortion (aIRR = 0.9; 95% CI, 0.8-1). They did, however, have an increased incidence of induced abortion (aIRR = 1.9; 95% CI, 1.6-2.1) from 1995-2021 compared with WGP.

After comparing the earlier (1995-2000) and later periods (2009-2021) of the study among WWH, the researchers found that aIRRs of childbirth, pregnancy and spontaneous abortion increased for WWH, whereas the aIRR of induced abortion remained increased across all time periods.

They added that additional investigation was done to assess the rate of multiple induced abortions among WWH compared with WGP and it showed that the risk of multiple induced abortions is increased 3 times among WWH compared with WGP across all time periods.

“Women newly diagnosed with HIV can expect to have children if they so wish,” Paulsen said. “Clinicians should be aware of a need to discuss contraceptive options with women with HIV to prevent unintended pregnancies and thereby also possible induced abortions.”

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