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Improved pregnancy outcomes with increasing antiretroviral coverage in South Africa

Overview of attention for article published in BMC Pregnancy and Childbirth, February 2016
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Title
Improved pregnancy outcomes with increasing antiretroviral coverage in South Africa
Published in
BMC Pregnancy and Childbirth, February 2016
DOI 10.1186/s12884-016-0821-3
Pubmed ID
Authors

Theron Moodley, Dhayendre Moodley, Motshedisi Sebitloane, Niren Maharaj, Benn Sartorius

Abstract

Universal multi drug antiretroviral treatment in pregnancy is a global priority in our bid to eliminate paediatric HIV infections although few studies have documented the impact of antiretroviral coverage on overall pregnancy outcomes. We conducted a maternity audit at a large regional hospital in South Africa during July-December 2011 and January-June 2014 with an aim to determine an association between pregnancy outcomes and the ARV treatment guidelines implemented during those specific periods. During 2011, women received either Zidovudine/sd Nevirapine or Stavudine/Lamivudine/Nevirapine if CD4+ count was < 350 cells/ml. During 2014, all HIV positive pregnant women were eligible for a fixed dose combination (FDC) of triple ARVs (Tenofovir/Emtracitabine/Efavirenz). In 2011, 622 (35.9 %) of 1732 HIV positive pregnant women received triple antiretrovirals (D4T/3TC/NVP) and in 2014, 2104 (94.8 %) of 2219 HIV positive pregnant women received the fixed dose combination (TDF/FTC/EFV). We observed a reduction in the proportion of unregistered pregnancies, caesarean delivery rate, still birth rate, very low birth weight rate, and very premature delivery rate in 2014. In a bivariate analysis of all 9,847 deliveries, unregistered pregnancies (2.2 %) and HIV infection (37.8 %) remained significant risk factors for SB(OR 6.36 and 1.43 respectively), PTD(OR 4.23 and 1.26 respectively),LBW (OR 4.07 and 1.26 respectively) and SGA(OR 2.17 and 1.151 respectively). In a multivariable analysis of HIV positive women only, having received AZT/NVP or D4T/3TC/NVP or EFV/TDF/FTC as opposed to not receiving any ARV was significantly associated with reduced odds of a SB (OR 0.08, 0.21 and 0.18 respectively), PTD (OR 0.52, 0.68 and 0.56 respectively) and LBW(0.37, 0.61 and 0.52 respectively). An improvement in birth outcomes is likely associated with the increased coverage of triple antiretroviral treatment for pregnant women. And untreated HIV infected women and women who do not seek antenatal care should be considered most at risk for poor birth outcomes.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 154 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 154 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 35 23%
Student > Ph. D. Student 18 12%
Researcher 14 9%
Student > Bachelor 13 8%
Student > Postgraduate 12 8%
Other 25 16%
Unknown 37 24%
Readers by discipline Count As %
Medicine and Dentistry 43 28%
Nursing and Health Professions 26 17%
Agricultural and Biological Sciences 10 6%
Pharmacology, Toxicology and Pharmaceutical Science 6 4%
Social Sciences 5 3%
Other 24 16%
Unknown 40 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 February 2016.
All research outputs
#14,850,834
of 24,892,887 outputs
Outputs from BMC Pregnancy and Childbirth
#2,727
of 4,642 outputs
Outputs of similar age
#206,042
of 411,571 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#38
of 58 outputs
Altmetric has tracked 24,892,887 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,642 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.2. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 411,571 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 58 others from the same source and published within six weeks on either side of this one. This one is in the 34th percentile – i.e., 34% of its contemporaries scored the same or lower than it.