Perinatal & Pediatric
HIV Status And Cardiometabolic Health During Pregnancy: A Cross-Sectional Analysis From A Prospective Southeast US Based Cohort Danielle Carson* Danielle Carson Carson Carson Carson Carson Carson Carson Carson Carson Carson Department of Epidemiology, Emory University Rollins School of Public Health
Cardiometabolic complications during pregnancy have increased in the past decade and pose heightened risks for women with HIV (WWH), who face compounded vulnerabilities from chronic inflammation, antiretroviral therapy (ART) exposure, and intersecting health disparities. We conducted a cross-sectional analysis of baseline data from pregnant participants at enrollment into STAR. We assessed associations between HIV status and cardiometabolic indicators (blood pressure, glucose, HbA1c, lipids) using linear regression and prevalent conditions (chronic hypertension (BP ≥140 or ≥90, medication use, or self-report diagnosis <20 weeks), hypertension in pregnancy (BP ≥140 or ≥90, medication use, or self-report diagnosis ≥20 weeks), type 2 diabetes (HgbA1c ≥6.5% or FBG ≥126 mg/dL, medication use, or self-report diagnosis < 24 weeks), and gestational diabetes (self-report diagnosis or study ascertainment)) using log-binomial regression. Prevalence was also examined overall and stratified by race and age group. Among 119 pregnant participants (80 WWH, 39 women without HIV (WWoH)), characteristics were: 73% identified as Non-Hispanic Black, median age 30.6 years, and 55% were obese, and most participants were multiparous, with 68% reporting two or more prior pregnancies. WWH vs WWoH had higher mean systolic blood pressure (112.6 vs 112.5 mmHg), diastolic blood pressure (70.3 vs 63.0 mmHg) and glucose levels (83.0 vs 75.8 mg/dL) but lower total (209.0 vs 231.0 mg/dL), HDL (68.0 vs 69.7 mg/dL), and LDL cholesterol (12.6 vs 131.7 mg/dL). Chronic hypertension was more prevalent among WWH (20% vs 8%, PR: 2.60, 95% CI: 0.81, 8.40), as was hypertension in pregnancy (15% vs 8%, PR: 1.95, 95% CI: 0.58, 6.51) and type 2 diabetes (13% vs 8%, PR: 1.65, 95% CI: 0.47, 5.57), while gestational diabetes was more prevalent among WWoH (4% vs 10%, PR: 0.37, 95% CI: 0.09, 1.55). Although overall prevalence ratios were higher among WWH, stratified analyses showed heterogeneity by age and race, with some older strata exhibiting high prevalence regardless of HIV status. These findings highlight substantial cardiometabolic vulnerability during pregnancy and the need for longitudinal follow up to assess age and race specific impacts of HIV.
