Table 1. Maternal Characteristics of Pregnancies by Timing of ARV Initiationa.
| Characteristic | Pregnancies, No. (%) | |||
|---|---|---|---|---|
| Total (N = 1867) | Receiving ARVs at Conception (n = 790) | Resuming ARVs During Pregnancy (n = 625) | Initiating ARVs During Pregnancy (n = 452) | |
| Race/ethnicityb | ||||
| Black | 1264 (67.7) | 512 (64.8) | 443 (70.9) | 309 (68.4) |
| White | 480 (25.7) | 228 (28.9) | 146 (23.4) | 106 (23.5) |
| Other | 19 (1.0) | 6 (0.8) | 7 (1.1) | 6 (1.3) |
| Hispanic ethnicity | 530 (28.4) | 243 (30.8) | 152 (24.3) | 135 (29.9) |
| Year of delivery | ||||
| 2008 | 106 (5.7) | 40 (5.1) | 38 (6.1) | 28 (6.2) |
| 2009 | 132 (7.1) | 35 (4.4) | 38 (6.1) | 59 (13.1) |
| 2010 | 201 (10.8) | 72 (9.1) | 66 (10.6) | 63 (13.9) |
| 2011 | 250 (13.4) | 91 (11.5) | 86 (13.8) | 73 (16.2) |
| 2012 | 214 (11.5) | 89 (11.2) | 71 (11.4) | 54 (11.9) |
| 2013 | 241 (12.9) | 101 (12.8) | 89 (14.2) | 51 (11.3) |
| 2014 | 223 (11.9) | 102 (12.9) | 72 (11.5) | 49 (10.8) |
| 2015 | 220 (11.8) | 104 (13.2) | 72 (11.5) | 44 (9.7) |
| 2016 | 213 (11.4) | 120 (15.2) | 68 (10.9) | 25 (5.5) |
| 2017 | 67 (3.6) | 36 (4.6) | 25 (4.0) | 6 (1.3) |
| Household annual income, $ | ||||
| >30 000 | 237 (12.7) | 133 (16.8) | 63 (10.1) | 41 (9.1) |
| >20 000-30 000 | 186 (10.0) | 86 (10.9) | 73 (11.7) | 27 (6.0) |
| ≤20 000 | 1353 (72.5) | 545 (69.0) | 456 (73.0) | 352 (77.9) |
| Unknown | 91 (4.9) | 26 (3.3) | 33 (5.3) | 32 (7.1) |
| Education less than high school | 568 (30.4) | 244 (30.9) | 191 (30.6) | 133 (29.4) |
| Site region | ||||
| Puerto Rico | 139 (7.4) | 58 (7.3) | 34 (5.4) | 47 (10.4) |
| West | 359 (19.2) | 182 (23.0) | 97 (15.5) | 80 (17.7) |
| South | 801 (42.9) | 287 (36.3) | 307 (49.1) | 207 (45.8) |
| Midwest | 153 (8.2) | 62 (7.8) | 53 (8.5) | 38 (8.4) |
| Northeast | 415 (22.2) | 201 (25.4) | 134 (21.4) | 80 (17.7) |
| Age at conception, mean (SD), y | 28.6 (6.1) | 29.7 (6.2) | 28.1 (5.8) | 27.2 (6.0) |
| Gestational age at entry to prenatal care, mean (SD), wk | 12.4 (6.7) | 10.7 (5.7) | 12.8 (6.7) | 14.7 (7.3) |
| Trimester at entry to prenatal careb | ||||
| First | 1281 (68.6) | 622 (78.7) | 409 (65.4) | 250 (55.3) |
| Second | 519 (27.8) | 157 (19.9) | 194 (31.0) | 168 (37.2) |
| Third | 65 (3.5) | 10 (1.3) | 22 (3.5) | 33 (7.3) |
| Substance use prior to ARV initiation in pregnancyb | ||||
| Tobacco | 213 (11.4) | NA | 132 (21.1) | 81 (17.9) |
| Alcohol | 98 (5.2) | NA | 63 (10.1) | 35 (7.7) |
| Illicit drugs | 126 (6.7) | NA | 80 (12.8) | 46 (10.2) |
| Maternal infectionsc | ||||
| Hepatitis B infectionb | 33 (1.8) | 13 (1.6) | 11 (1.8) | 9 (2.0) |
| Hepatitis C infectionb | 24 (1.3) | 8 (1.0) | 13 (2.1) | 3 (0.7) |
| Using Medicaid to pay child’s medical billsb | 1515 (81.1) | 622 (78.7) | 534 (85.4) | 359 (79.4) |
| Maternal medication use during pregnancyd | ||||
| Tuberculosis medicationb | 2 (0.1) | 1 (0.1) | 0 | 1 (0.2) |
| Psychiatric medicationsb | 228 (12.2) | 119 (15.1) | 77 (12.3) | 32 (7.1) |
| Perinatal HIV acquisitionb | 199 (10.7) | 111 (14.1) | 85 (13.6) | 3 (0.7) |
| Maternal HIV diagnosis during pregnancy | 314 (16.8) | 0 | 0 | 314 (69.5) |
| Earliest HIV disease measures during pregnancy | ||||
| Viral load, copies/mLb | ||||
| >1000 | 772 (41.3) | 126 (15.9) | 342 (54.7) | 304 (67.3) |
| >400-1000 | 111 (5.9) | 26 (3.3) | 41 (6.6) | 44 (9.7) |
| ≤400 | 962 (51.5) | 622 (78.7) | 238 (38.1) | 102 (22.6) |
| CD4 count, cells/μLb | ||||
| <200 | 227 (12.2) | 72 (9.1) | 106 (17.0) | 49 (10.8) |
| 200-349 | 346 (18.5) | 107 (13.5) | 139 (22.2) | 100 (22.1) |
| ≥350 | 1260 (67.5) | 590 (74.7) | 372 (59.5) | 298 (65.9) |
| Most intense ARV regimen during pregnancyd,e | ||||
| ≥3 ARV drug classes | 145 (7.8) | 87 (11.0) | 45 (7.2) | 13 (2.9) |
| Triple ARV regimen from 2 drug classes | 1576 (84.4) | 670 (84.8) | 513 (82.1) | 393 (86.9) |
| ≥3 NRTIs | 94 (5.0) | 9 (1.1) | 46 (7.4) | 39 (8.6) |
| Other ARV regimen | 49 (2.6) | 24 (3.0) | 19 (3.0) | 6 (1.3) |
| 2 NRTIs | 1 (0.05) | 0 | 0 | 1 (0.2) |
| Zidovudine alone | 1 (0.05) | 0 | 1 (0.2) | 0 |
| No ARV or taking ARV for <3 d | 1 (0.05) | 0 | 1 (0.2) | 0 |
| Trimester of initiating ARV during pregnancy | ||||
| First | 1184 (63.4) | 790 (100) | 301 (48.2) | 93 (20.6) |
| Second | 570 (30.5) | 0 | 280 (44.8) | 290 (64.2) |
| Third | 113 (6.1) | 0 | 44 (7.0) | 69 (15.3) |
Abbreviations: ARV, antiretroviral medication; NA, not applicable; NRTIs, nucleoside reverse transcriptase inhibitors.
Unique pregnancies that had a reported delivery after 2007 and had detailed maternal ARV exposure information and completed maternal HIV history form; women who did not receive any ARVs during pregnancy were excluded.
Some characteristics not available for all participants and handled as missing, including race/ethnicity (n = 104 missing); trimester of entry into prenatal care (n = 2); substance use not available among women initiating ARVs prior to conception; tobacco use (n = 13); alcohol use (n = 11); illicit drug use (n = 15); hepatitis B status (n = 145); hepatitis C status (n = 484); using Medicaid to pay child’s medical bills (n = 10); tuberculosis medication taken in pregnancy (n = 11); psychiatric medication taken in pregnancy (n = 11); perinatal HIV acquisition (n = 46); maternal HIV diagnosis in pregnancy (n = 15); earliest viral load in pregnancy (n = 22); and earliest CD4 cell count in pregnancy (n = 34).
Hepatitis B infection was defined as having a positive hepatitis surface antigen test result. Hepatitis C was defined as having a positive hepatitis C RNA test result.
Tuberculosis or psychiatric medications taken during pregnancy with potential interactions with ARV drugs were included.
The most intense ARV regimen prescribed during pregnancy was defined based on duration of use during pregnancy of 3 or more days and a hierarchy from the most to least intense as (1) ARV regimens consisting of 3 or more ARVs, (2) triple ARV regimens from 2 drug classes, (3) 3 or more NRTIs, (4) other ARV regimens, (5) 2 NRTIs, (6) zidovudine with or without single-dose nevirapine, and (7) no ARVs. If a switch in prescribed regimens occurred during pregnancy, the most intense regimen was selected, so long as it was used for 3 or more days during pregnancy. Where a regimen switch occurred within the same intensification category, the regimen used for the longest duration was selected for analysis.