HIV positive women are much more likely to suffer from anaemia and high blood pressure in pregnancy and deliver babies with lower birth weights and retarded growth, according to research in the latest UK-based Journal of Clinical Nursing.

A team from the University of Witwatersrand in South Africa compared 212 HIV positive mothers-to-be with 101 women who had tested negative.

“Latest statistics suggest that more than a quarter of pregnant women in South Africa are HIV positive and that global rates are continuing to rise” says lead researcher Dr Candice Bodkin.

“It has already been established that HIV and AIDS can exaggerate some of the problems normally experienced in pregnancy. But we believe that this is the first study to link being HIV positive and pregnant with higher levels of anaemia and raised blood pressure.”

The researchers identified a number of key health issues facing HIV positive pregnant women, including:

 
• A significantly higher risk of developing anaemia compared with women who were HIV negative. This can lead to lower tolerance to severe bleeding after birth, one of the most common causes of maternal death.  
• An increased risk of developing pregnancy-induced hypertension compared with HIV negative women (17 versus 10 per cent), but no greater risk of developing eclampsia, a potentially life-threatening condition characterised by high blood pressure, swelling and protein in the urine.  
• Lower maternal weight, with HIV positive women weighing six per cent less (just under five kilograms) than women who tested negative - a possible indication that HIV was progressing to the early stages of AIDS in the women studied.  
• Double the risk of a urinary tract infection (16 per cent versus eight per cent) a five-fold increase in syphilis (six per cent versus one per cent) and a higher level of abnormal vaginal discharge (33 per cent versus 25 per cent).  
• Slightly earlier delivery (38 weeks versus 38.5 weeks) a five per cent lower birth weight (2970 grams versus 3138 grams) and a five per cent chance of growth retardation in the womb.

Women with HIV also attended significantly fewer antenatal appointments and 17 per cent received no antenatal care. The HIV and non HIV groups were selected from 1,540 women receiving prenatal care at a Gauteng hospital over a 15-month period. 776 agreed to be HIV tested and over 31 per cent of these were positive. Women were then classified as normal, moderate and high risk pregnancies and randomly selected within those categories to provide a representative sample. The HIV positive group included twice as many women in each category as the HIV negative control group. “Raising awareness of health issues among HIV positive women who are pregnant is very important” says Dr Bodkin. “The Department of Health has linked the high rates of maternal illness and death in South Africa with the absence of accepted and practical guidance for dealing with women who are pregnant and HIV positive. “We believe that this study provides a good starting point for the development of clinical practice guidelines and hope that it will prove useful for other countries with similar problems.” http://www.www.blackwellpublishing.com/jcn