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Murphy EM, Keller JM, Powell AM, Milio LA, Sheffield JS, Argani CH, Livingston AG, Anderson JR. Women Living with Human Immunodeficiency Virus with Intended and Unintended Pregnancy: Characteristics and Patient Outcomes. J Womens Health (Larchmt) 2023; 32:445-451. [PMID: 36602512 DOI: 10.1089/jwh.2022.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Rates of unintended pregnancy may be higher in women living with human immunodeficiency virus (WLWH) than in the general population, and it is unclear how populations of WLWH with intended and unintended pregnancy differ. We compared baseline characteristics and outcomes between WLWH with intended and unintended pregnancy. Materials and Methods: We conducted a retrospective analysis of WLWH enrolled in a human immunodeficiency virus (HIV) and Pregnancy clinic from 2003 to 2014. Data were analyzed using descriptive statistics, chi-square test, Student's t-test, one-way analysis of variance, and linear and logistic regression analysis. Two-tailed p-value <0.05 was considered significant. The study was approved by the Johns Hopkins University School of Medicine Institutional Review Board. Results: Sixty-nine (27.1%) of 255 women reported an intended pregnancy. Women with intended pregnancy (WWIP) were more likely to be older, White, married, privately insured, and college educated. WWIP were less likely to use tobacco (15.9% vs. 44.2%, p < 0.001), alcohol (2.9% vs. 11.1%, p = 0.041), opiates (0.0% vs. 19.3%, p < 0.001), or cocaine (2.9% vs. 21.0%, p < 0.001) during pregnancy, more likely to disclose their HIV status to the father of the baby by delivery (100.0% vs. 15.8%, p < 0.001), and more likely to receive less effective contraception at delivery (condoms 14.9% vs. 4.8%, p = 0.024; sterilization 11.9% vs. 22.1%, p = 0.028). In multivariate regression analysis, pregnancy intendedness was an important predictor of nondetectable viral load at pregnancy entry but not at delivery. Conclusions: WLWH vary in their baseline characteristics and pregnancy outcomes depending on pregnancy intendedness, highlighting the need to improve pregnancy timing in WLWH and intensify interventions for women with unintended pregnancy.
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Affiliation(s)
- Emily M Murphy
- Division of Hospital Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jean M Keller
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anna M Powell
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lorraine A Milio
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeanne S Sheffield
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cynthia H Argani
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alison G Livingston
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jean R Anderson
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Koopman I, Callaghan-Koru JA, Alaofin O, Argani CH, Farzin A. Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery: a qualitative study on clinician perspectives. J Clin Nurs 2016; 25:1367-76. [DOI: 10.1111/jocn.13227] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Inez Koopman
- Selective Utrecht Medical Master; Utrecht University; Utrecht The Netherlands
| | | | - Oluwatope Alaofin
- Department of Gynecology and Obstetrics; Johns Hopkins Bayview Medical Center; Baltimore MD USA
| | - Cynthia H. Argani
- Labor and Delivery at Johns Hopkins Bayview Medical Center; Baltimore MD USA
- The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Azadeh Farzin
- Department of International
Health; International Center for Maternal and Newborn Health; Johns Hopkins Bloomberg School of Public Health; Baltimore MD USA
- Division of Neonatology; Department of Pediatrics; The Johns Hopkins University School of Medicine; Baltimore MD USA
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Cordeiro CN, Savva Y, Vaidya D, Argani CH, Hong X, Wang X, Burd I. Mathematical Modeling of the Biomarker Milieu to Characterize Preterm Birth and Predict Adverse Neonatal Outcomes. Am J Reprod Immunol 2016; 75:594-601. [DOI: 10.1111/aji.12502] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/22/2016] [Indexed: 12/17/2022] Open
Affiliation(s)
- Christina N. Cordeiro
- Integrated Research Center for Fetal Medicine; Department of Gynecology and Obstetrics; Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Yulia Savva
- Center for Child and Community Health Research; Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Dhananjay Vaidya
- Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Medicine; Department of Population, Family and Reproductive Health; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - Cynthia H. Argani
- Integrated Research Center for Fetal Medicine; Department of Gynecology and Obstetrics; Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Xiumei Hong
- Department of Medicine; Department of Population, Family and Reproductive Health; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - Xiaobin Wang
- Department of Medicine; Department of Population, Family and Reproductive Health; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - Irina Burd
- Integrated Research Center for Fetal Medicine; Department of Gynecology and Obstetrics; Johns Hopkins University School of Medicine; Baltimore MD USA
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Stohl HE, Silva AM, Argani CH, Anderson JR. Fulminant hepatic failure associated with antiretroviral therapy in a pregnant woman. Int J Gynaecol Obstet 2009; 106:260-1. [PMID: 19477440 DOI: 10.1016/j.ijgo.2009.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 04/05/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Hindi E Stohl
- Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
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