HIV-AIDS related maternal mortality in Benin city, Nigeria

Abstract

SUMMARYObjective: To determine the causes and characteristics of maternal deaths in HIV-infected women. Design: A retrospective study of maternal deaths in a cohort of HIV-infected women. Setting: A facility-based maternal death review using case records and mortality summaries. Methods: Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4-year period. Causes and circumstances surrounding each maternal death were identified. Result: One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancyrelated sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia. Conclusion: HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections.

Indirect causes of severe adverse maternal outcomes: a secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health

“…HIV/AIDS is an increasing contributor of indirect as well as direct causes of MDs in many countries, especially in sub‐Saharan Africa . The most common causes of MD among women with HIV were AIDS, pneumonia, tuberculosis, and meningitis .…”

“…[5][6][7][8]14,16 HIV/AIDS is an increasing contributor of indirect as well as direct causes of MDs in many countries, especially in sub-Saharan Africa. 9,[17][18][19] The most common causes of MD among women with HIV were AIDS, pneumonia, tuberculosis, and meningitis. 20 The prevalence of HIV/AIDS in this current report was very low, and should be cautiously interpreted because of the high possibility of under-reporting.…”

Pregnancy and HIV disease progression: a systematic review and meta‐analysis

“…; Onakewhor et al . ). In global mathematical models of maternal mortality, varying assumptions are made about the proportion of deaths to HIV‐infected pregnant and post‐partum women which should be classified as maternal.…”

“…Attributing the death of a pregnant or post-partum woman to HIV not only requires knowledge of the woman's HIV status, but it also requires decisions about whether it is indirectly attributable or coincidental to the pregnancy (the latter are not classified as maternal deaths). Clinicians assigning causes of death classify most deaths of HIV-infected pregnant or post-partum women as indirectly attributable to the pregnancy, although justifications for this choice are rarely provided (Black et al 2009;Onakewhor et al 2011). In global mathematical models of maternal mortality, varying assumptions are made about the proportion of deaths to HIV-infected pregnant and post-partum women which should be classified as maternal.…”

The Biosocial Burden of HIV and Malaria Co-infection Among Pregnant Mothers

“…The persistently high maternal mortality in Africa, Nigeria inclusive, may be associated with increasing numbers of HIV-associated death [21]. HIV was among the major causes of death among women in the reproductive age [20].…”