ackground To define in women with HIV in early pregnancy the prevalence and temporal trends of smoking and the role of smoking status and smoking level as copredictors of adverse maternal and neonatal outcomes.Methods Multicenter observational study of HIV-positive pregnant women. Main outcome measures were fetal growth restriction, preterm delivery and low birthweight. The associations between smoking and outcomes were evaluated in univariate and multivariate analyses. Results The overall prevalence of reported smoking (at least one cigarette per day) was 25.6% (792/3097), with a significant decrease in recent years (19.0% in 2013-2018). Women who smoked were less commonly African, had lower body mass index, older age, a longer history of HIV infection and higher CD4 cell counts. Smoking was associated with HCV coinfection, history of drug use, detectable HIV viral load, sexually transmitted diseases, recent use of substances and alcohol, and with urinary infections, anemia, and hypertension during pregnancy. In multivariable analyses smoking significantly increased the risk of low birthweight (adjusted odds ratio [AOR]: 1.689, 95%CI 1.218-2.341) and fetal growth restriction [FGR] (AOR 1.884, 95%CI 1.266-2.802). The other cofactors significantly associated with FGR were hypertension (AOR 3.134, 95%CI 1.311-7.493) and maternal underweight (AOR 2.081, 95%CI 1.243-3485), with an association approaching statistical significance for recent substance use (AOR 1.999, 95%CI 0.929-4.301). Conclusions Smoking remains common among pregnant women with HIV. Its association with comorbidities and adverse outcomes indicates that smoking cessation programs in this population may have a significant impact on neonatal and maternal health.
Prevalence, correlates and outcomes of smoking in pregnant women with HIV: data from a national observational study in Italy
Vimercati A;
In corso di stampa
Abstract
ackground To define in women with HIV in early pregnancy the prevalence and temporal trends of smoking and the role of smoking status and smoking level as copredictors of adverse maternal and neonatal outcomes.Methods Multicenter observational study of HIV-positive pregnant women. Main outcome measures were fetal growth restriction, preterm delivery and low birthweight. The associations between smoking and outcomes were evaluated in univariate and multivariate analyses. Results The overall prevalence of reported smoking (at least one cigarette per day) was 25.6% (792/3097), with a significant decrease in recent years (19.0% in 2013-2018). Women who smoked were less commonly African, had lower body mass index, older age, a longer history of HIV infection and higher CD4 cell counts. Smoking was associated with HCV coinfection, history of drug use, detectable HIV viral load, sexually transmitted diseases, recent use of substances and alcohol, and with urinary infections, anemia, and hypertension during pregnancy. In multivariable analyses smoking significantly increased the risk of low birthweight (adjusted odds ratio [AOR]: 1.689, 95%CI 1.218-2.341) and fetal growth restriction [FGR] (AOR 1.884, 95%CI 1.266-2.802). The other cofactors significantly associated with FGR were hypertension (AOR 3.134, 95%CI 1.311-7.493) and maternal underweight (AOR 2.081, 95%CI 1.243-3485), with an association approaching statistical significance for recent substance use (AOR 1.999, 95%CI 0.929-4.301). Conclusions Smoking remains common among pregnant women with HIV. Its association with comorbidities and adverse outcomes indicates that smoking cessation programs in this population may have a significant impact on neonatal and maternal health.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
