Risk of Preeclampsia in Human Immunodeficiency Virus–Infected Pregnant Women

OBJECTIVE:To evaluate the risk of preeclampsia in pregnant women with human immunodeficiency virus (HIV). METHODS:This is a 26-year population-based retrospective cohort study. Human immunodeficiency virus–infected pregnant women were compared with a HIV-negative comparison group. The primary outcome was the incidence of preeclampsia. We planned subgroup analysis according to antiretroviral therapy. RESULTS:A total of 84,725 women were included in the analysis, of whom 453 were HIV-infected and 84,272 HIV-negative. Of the 453 HIV-infected women, 301 (66.4%) received highly active antiretroviral therapy (HAART group) during pregnancy, whereas 152 (33.6%) did not. After adjusting for confounders, we found that HIV-infected women had a significantly higher risk of preeclampsia (10.2% compared with 4.1%; adjusted odds ratio [OR] 2.68, 95% confidence interval [CI] 1.96–3.64), preeclampsia with severe features (4.0% compared with 2.0%; adjusted OR 2.03, 95% CI 1.26–3.28), early-onset (3.5% compared with 1.4%; adjusted OR 2.50, 95% CI 1.51–4.15) and late-onset preeclampsia (6.6% compared with 2.6%; adjusted OR 2.64, 95% CI 1.82–3.85), and preterm birth at less than 37 weeks of gestation (11.0% compared with 4.7%; adjusted OR 2.50, 95% CI 1.86–3.37) compared with the comparison group. Human immunodeficiency virus–infected women who received HAART had a significantly higher risk of preeclampsia compared with women without HIV (13.0% compared with 4.1%; adjusted OR 3.52, 95% CI 2.51–4.94) and compared with the non-HAART group (13.0% compared with 4.6%; adjusted OR 3.08, 95% CI 1.34–5.07). The non-HAART group had a similar risk compared with women without HIV (4.6% compared with 4.1%; adjusted OR 1.14, 95% CI 0.53–2.44). CONCLUSION:Human immunodeficiency virus–infected women had an increased risk of preeclampsia. Some of this risk seems to be linked to HAART.