Open Collections

Abstract

Background: For pregnant women living with HIV (WLWH), engagement in care is crucial to maternal health and reducing the risk of perinatal transmission. To date, there have been no studies in Canada examining the impact of the COVID-19 pandemic on pregnant WLWH. Methods: This was a retrospective cohort study assessing the impact of the pandemic on perinatal outcomes for pregnant WLWH using data from the Perinatal HIV Surveillance Program in British Columbia (BC), Canada. We compared maternal characteristics, pregnancy outcomes, and clinical indicators related to engagement with care between a pre-pandemic (January 2017–March 2020) and pandemic cohort (March 2020–December 2022). We investigated preterm birth rates with explanatory variables using logistic regression analysis. Results: The pre-pandemic cohort (n=87) had a significantly (p<0.05) lower gestational age at first antenatal encounter (9.0 vs 11.8) and lower rates of preterm births compared to the pandemic cohort (n=56; 15% vs 37%). Adjusted odds of preterm birth increased with the presence of substance use in pregnancy (aOR=10.45, 95% CI=2.19-49.94) in WLWH. There were two cases of perinatal transmission of HIV in the pandemic cohort, while the pre-pandemic cohort had none. Conclusions: The pandemic had pronounced effects on pregnant WLWH and their infants in BC including higher rates of preterm birth and higher gestational age at first antenatal encounter. The non-statistically significant increase in perinatal transmission rates is of high clinical importance.