Assessment of the relationship between maternal cardiometabolic health and fetal growth in pregnant women living with HIV on antiretroviral therapy in Mthatha, South Africa.

BACKGROUND

The use of antiretroviral therapy (ART) during pregnancy among women living with human immunodeficiency virus (HIV) may adversely affect their cardiometabolic health, but its influence on fetal growth remains underexplored. This study aimed to investigate the relationship between maternal cardiometabolic health and fetal growth in pregnant women living with HIV receiving ART in Mthatha, South Africa.

METHODS

A pilot study included 21 HIV-positive and 53 HIV-negative pregnant women, measuring anthropometric parameters and blood pressure. Cardiometabolic risk factors were assessed, including dyslipidemia, glycemia, oxidative stress, endothelial function, and inflammatory markers. Noninvasive vascular function indicators, including uterine artery pulsatile index (UtA PI), flow-mediated slowing (FMS), carotid-femoral pulse wave velocity (cfPWV), and ankle-brachial index (ABI) were evaluated. Fetal growth parameters, including femur length (FL), biparietal diameter, head circumference (HC), abdominal circumference (AC), and estimated fetal weight, were recorded. Relationships between maternal health and fetal growth were analyzed with a significance threshold of p ≤ 0.05.

RESULTS

Prehypertension was more common among pregnant women living with HIV (14.29% vs. 1.89%). Additionally, higher cfPWV, UtA, and LDL-C levels were noted in the HIV-positive group (p ≤ 0.05). A negative correlation (p ≤ 0.05) was found between maternal UtA PI and fetal growth parameters such as AC, FL and HC.

CONCLUSION

Vascular dysfunction was observed in pregnant women living with HIV on ART coupled with an inverse association between maternal vascular function and fetal growth suggesting that impaired maternal vascular function may limit placental blood flow and potentially affect fetal growth.