Does HIV Cause Miscarriage?
Pregnancy and HIV—can it work?
Is there a risk of miscarriage with HIV?
Although women with HIV can indeed have a successful pregnancy and deliver a healthy baby who is not infected with HIV, research does show an increased risk of late-term loss of the fetus.
However, the overall health and circumstances of the mother and other factors should be considered when weighing this information. The circumstances of some women may not resemble those of women in the research studies.
Many of the women who miscarried also had other factors in their lives, such as poverty, migration away from their native country and instances of partner abuse or domestic violence.
For the past decade or so, advances in antiretroviral treatments (the 'cocktail' therapy) have greatly improved the chance of an HIV-positive woman giving birth to a healthy baby.
This means that even if a woman is infected with the Human Immunodeficiency Virus (HIV), she can have a baby who is free of that virus. Certainly, though, having HIV should be taken seriously when contemplating pregnancy; it is a manageable condition, but one requiring changes in lifestyle and regular monitoring.
If you have HIV, or if you're dating or married to a person with HIV, this article offers information about the risks of miscarriage with HIV-infected women compared to women who do not have HIV.
Research on Miscarriage and HIV
At least two research studies have shown an increase in miscarriage among HIV-positive women.
A study done in Uganda (in 2004) showed a dramatic increased risk of HIV-positive women suffering miscarriage in the late pregnancy. The contrast (five times higher than miscarriage instances in non-HIV mothers) created an interest in doing similar research in England.
In 2007, a London hospital reviewed several years of pregnancy data of 242 pregnant women, which showed an overall pregnancy loss rate of eight percent among those studied, compared to two percent in the general (non-HIV) population, and four percent in the economic-depressed area in which the research was done. This would suggest a fourfold increase in the risk of miscarriage for women with HIV.
Only four of the women studied were born outside of sub-Saharan Africa, and none had a recorded history of injecting drugs or alcohol abuse.
However, there were higher instances of other problems, such as household/partner violence and emotional distresses, and some had an earlier history of miscarriage. These factors cannot be set aside in determining the overall risk of miscarriage for women with HIV compared to non-HIV infected women.
Possible Causes of Miscarriage in HIV-Infected Women
The pregnancy losses observed in the London study occurred after 14 weeks, and as far into the pregnancies as 39 weeks (a normal pregnancy term is 40 weeks).
In about 70 percent of the pregnancy losses (10 of 14 assessed), records showed an inflammation of the membrane covering the fetus. This type of inflammation generally stems from a bacterial infection in the region of the cervical or vaginal area that migrates to the uterus and then affects the fetus.
Researchers in this study determined the cause of miscarriage to remain unclear, but the above information is helpful for future research. Earlier studies showed an increase of similar membrane inflammation, but in those instances, the infection was felt to be transmitted inutero (rather than from an external site, such as the vaginal area).
HIV-Positive Women and Women With AIDS Can Deliver Healthy Babies
As mentioned above, the 'normal' rate of miscarriage, for women who do not have HIV and who are not experiencing other socioeconomic issues, is two percent. Even a four-fold increase (such as that shown in the London study) reflects less than a 10 percent chance of miscarriage for women who have HIV.
Women with HIV do get pregnant, and through good care during gestation, they can deliver healthy babies. Women who do not have HIV should always explore whether a potential partner is at risk of being infected, and use appropriate protection to avoid transmitting the virus if they are dating someone with HIV.
Loss of a pregnancy is heartbreaking. As many women know, the minute you know you are pregnant, the baby is very real to you and is already your child. Although the overall risk may seem low (less than 10 percent), these risks should not be taken lightly.
The recent advances in the treatment of HIV and the individual circumstances of each woman should be considered when attempting to get pregnant. One way to safeguard your partner (since HIV can be transmitted from women to men) is to use artificial insemination to conceive.
If you are already pregnant, you should find a good physician, preferably one experienced in following pregnancies with women who have HIV. Follow his or her directions, get plenty of rest and eat well, and follow good hygiene practices to help avoid health problems during your pregnancy.
This article is presented for informational purposes and is not designed to give medical advice. Marcy Goodfleisch has a Master of Arts degree and is the former clinic administrator of the David Powell HIV Clinic in Austin, Texas.