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Obstetrics & Gynecology 2004;104:238-242
© 2004 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Does Human Immunodeficiency Virus Infection Protect Against Preeclampsia-Eclampsia?

K A. Frank, MBBCh, E J. Buchmann, MBBCh, MSc(Med) and R C. Schackis, MBChB

From the Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.

Address reprint requests to: Professor E. J. Buchmann, P.O. Box 5622, Weltevredenpark, 1715 South Africa; e-mail: buchmannej{at}medicine.wits.ac.za.

OBJECTIVE: In view of recent suggestions that human immunodeficiency virus (HIV) infection may protect against preeclampsia, this study was done to evaluate whether untreated HIV-positive pregnant women have a lower rate of preeclampsia-eclampsia than HIV-negative women.

METHODS: Subjects for this study were pregnant women from Soweto, South Africa, who gave birth from March to December 2002 at midwife-run clinics or at the Chris Hani Baragwanath Hospital and in whom the HIV status was known. A sample size calculation indicated that 2,588 subjects would be required to show statistical significance at P < .05 with a power of 80% for a reduction in the rate of preeclampsia from 8% to 5% with HIV seropositivity, assuming an HIV seroprevalence rate of 30%. Data collection was by record review from randomly selected patient files and birth registers.

RESULTS: In the total sample of 2,600 women, 1,797 gave birth at the hospital and 803 at the midwife-run clinics. The HIV seroprevalence rate was 27.1%. Hypertension was found in 17.3% of women, with 5.3% having preeclampsia-eclampsia. The rates of preeclampsia-eclampsia were 5.2% in HIV-negative and 5.7% in HIV-positive women (P = .61). CD4 count results were available for only 13 women (0.5%).

CONCLUSION: Human immunodeficiency virus seropositivity was not associated with any reduction in the risk of developing preeclampsia-eclampsia.

LEVEL OF EVIDENCE: II-2






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