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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 4

Category: Infectious Diseases

Poster Session 4

(1255) HIV and pregnancy outcomes: An updated retrospective cohort analysis

Thursday, February 12, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Sarena Hayer, MA, MD, MSc (she/her/hers)

    Maternal Fetal Medicine Fellow
    Cedars-Sinai Health Sciences University
    Los Angeles, California, United States

    • Coauthor(s)

  • Bharti Garg, MBBS, MPH (she/her/hers)

    Biostatistician 3
    Oregon Health & Science University
    Oregon Health & Science University, Oregon, United States

  • Jamie O. Lo, MD

    Associate Professor
    Oregon Health & Science University
    Oregon Health & Science University, Oregon, United States

  • Aaron B. Caughey, MD, PhD

    Chair and Professor of Obstetrics and Gynecology
    Oregon Health & Science University
    Oregon Health & Science University, Oregon, United States

  • IC

    Irina Cassimatis

    Oregon Health & Science University
    Oregon Health & Science University, Oregon, United States

Objective:
While human immunodeficiency virus (HIV) in the United States (US) has declined, HIV in pregnancy remains a relevant clinical concern. Historically, pregnancies complicated by HIV-positive status have been associated with adverse perinatal outcomes. Despite improvements in screening and timely treatment, recent data on perinatal outcomes among pregnant individuals living with HIV remain limited. The objective of this study is to examine the association between HIV-positive status in pregnancy and adverse outcomes in a contemporary cohort.

Study Design:
This is a retrospective cohort study using linked vital statistics and hospital discharge data for births in California (2008-2020). We included HIV-positive pregnant individuals with a singleton gestation who delivered between 23 and 42 weeks. HIV-positive status was identified using ICD-9 (0.42x) and ICD-10 (B20) codes. Chi-square tests and multivariable Poisson regression models were used to assess risk of outcomes.

Results:
Compared to those without HIV, HIV-positive pregnant individuals (n=552) were more likely to be 35 years or older (29.5% vs. 20.5%; p< 0.001) and non-Hispanic Black (27.7% vs. 4.9%; p< 0.001). They also had less prenatal care (5.0% vs. 2.4%; p< 0.001), attained high school or less education (64.9% vs. 42.8%; p< 0.001), and were more likely to be publicly insured (84.1% vs. 51.6%; p< 0.001). On multivariate regression, HIV-positive status was associated with increased risk of placental abruption (aRR=1.87, 95% CI 1.10, 3.18), postpartum hemorrhage (aRR=2.19, 95% CI 1.61, 2.96), and severe maternal morbidity (aRR=3.72, 95% CI 2.68, 5.17). HIV-positive status was also associated with increased risk of preterm birth < 37 weeks (aRR=1.94, 95% CI 1.61, 2.34), neonatal intensive care unit (NICU) admission (aRR=1.86, 95% CI 1.60, 2.16), and respiratory distress syndrome (aRR= 2.25, 95% CI 1.68, 3.01).

Conclusion:
Despite changes to the HIV landscape in the US, HIV-positive status remains associated with increased risk of perinatal outcomes.