Effect of Successive Single-gestation Pregnancies on the Course of Maternal Human Immunodeficiency Virus Disease and Perinatal Transmission

Objective: This study was undertaken to examine the effect of successive pregnancies over a 3-year period on the course of maternal human immunodeficiency virus (HIV) infection and the rate of perinatal transmission of HIV. Methods: A retrospective analysis of 32 pregnancies in 14 known HIV-infected women vs. a matched control group of HIV-infected women who had been pregnant only once was done. Results: The multiple-pregnancy group was similar to the single-pregnancy group for age, race, duration of known HIV infection, initial CD(4) count, and date of first pregnancy. The delivery data were similar as well. The CD(4) counts in the multiple-pregnancy group fell from 595 to 460, while counts in the single-pregnancy group fell comparably from 669 to 638, both over 37 months (P = 0.1476). Five of 5 second-born infants of known serostatus vs. 8 of 21 first-born infants were HIV-infected (P < 0.05). Conclusions: Successive pregnancies do not alter the course of HIV infection in asymptomatic women followed up to 3 years. The infants of second pregnancies of known HIV-infected women may be at higher risk for perinatal transmission.