Incidence and Predictors of Pregnancy Among Patients on ART and Pre-Art; A Retrospective Cohort Study

Introduction- HIV care and treatment services are in a unique position to address the childbearing desires of HIV-infected individuals and to ensure safe pregnancy and delivery. However, in Ethiopia incidence and predictors of pregnancy among pre-ART and ART women is not addressed despite its importance.

Objective- the study is aimed to assess the incidence and predictors of pregnancy among Pre-ART and On-ART women in health facilities of kolfe keranio sub-city, AA, Ethiopia, 2011.

Methods- In health facilities of kolfe keranio sub-city, Addis Ababa a retrospective follow-up study from 2006 to 2011 was conducted. A total of 661 women’s charts were selected by Simple random sampling and reviewed. Data was cleared, checked and entered by EPI-INFO version 3.5.1 and analyzed by SPSS version 16.  Descriptive statistics, incidence rate of pregnancy in person-years of follow-up is reported. Kaplan Meir survival curve is used to estimate the probabilities of becoming pregnant. Cox proportional hazard model is used and results will be expressed as hazard ratio with 95% confidence interval. 

Results- the incidence of pregnancy among women who enrolled in HIV care and treatment programs is 6.5 per 100 person-years. This total comprised of 21 incident pregnancies with rate 3.7 per 100 person-years in the pre-ART period and 67 incident pregnancies with rate 8.3 per 100 person years in the ART period. There is also significant difference in pregnancy experience between the two periods. Having 1 to 4 children HR 0.185(95% CI 0.09, 0.99), non barrier Methods of contraception use HR 0.54(95%CI 0.32, 0.90), WHO stage (p-value=0.002), CD4 current (p-value <0.0001) and ART use HR 2.7(95%CI 1.5, 4.99) are predictors of pregnancy in HIV infected women.

Conclusion- the incidence of pregnancy in HIV infected women is increasing, highlighting the urgent need to make pregnancy-related services a central component of HIV care and ART program