Inter-pregnancy interval and pregnancy outcomes among HIV positive mothers in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria

Abstract

Abstract Background: Both short and long inter-pregnancy intervals have been associated with higher risk of adverse pregnancy
outcomes. More so, short interpregnancy interval among HIVpositive women implies higher birth rate and subsequently a
higher number of neonates exposed to HIV and potentially at risk of mother-to-child transmission.

Aims: To study the influence of inter-pregnancy interval on pregnancy outcomes among booked HIV-positive mothers with singleton live-births at Nauth, Nnewi.

Methods: A cross-sectional study was carried out with the aid of  structured questionnaires, maternal clinical records and relevant anthropometry, between May and December 2011, among booked multiparous HIV-positive mother/singleton newborn pairs at
NAUTH, Nnewi.

Results: More than half (56.5%) of the 175 multiparous HIVpositive women studied had short inter-pregnancy interval (<18
months). Short inter-pregnancy interval was signi ficantly associated with adverse maternal and perinatal outcomes like
maternal anaemia (X2 =14.95, p=0.021) and low values of maternal orneonatal  anthropometric parameter s.
However only adverse maternal outcomes and MAC/OFC ratio of t h e n e o n a t e s r e ma i n e d significantly associated with short Inter-pregnancy interval after logistic regression analysis. Long inter-pregnancy interval was significantly associated with low values of neonatal anthropometric parameters and maternal MAC less than 25cm (X2=15.10, p=0.019) as well as third trimester weight gain rate less than 250g/week (X2 =31.20, p= 0.000). The proportion of mothers with long interpregnancy
that had anaemia or intra-partum BMI less than 25kg/ m2 differed only slightly from that of those with inter-pregnancy interval of 18-59 months.

Conclusion: Inter-pregnancy interval of 18 to 59 months is significantly associated with the lowest risk of both adverse maternal and fetal outcomes among HIV-positive women.