Table 2 Summary characteristics of the 32 selected studies and their methodological quality score
Authors and publication date | Countries | Study period | Study design | Inclusion criteria | Exclusion criteria | Jadad scale | Newcastle–Ottawa scale |
|---|---|---|---|---|---|---|---|
Delicio et al. (2018) [34] | Brazil | 2000–2015 | Single-site cohort | Pregnant women HIV infected and new-borns seen at the Obstetrics Clinic; women with or without health insurance | Not mentioned | NA | 8/9 |
Townsend et al. (2006) [35] | UK, Ireland | 1990—2003 | Multi-site cohort (NSHPC) | Live birth or stillbirth in women diagnosed before delivery; Delivery reported to the NSHPC before 2004 | No information about antiretroviral combination and exposure period | NA | 5/9 |
Malaba et al. (2017) [36] | South Africa | 2013–2015 | Prospective single-site cohort | Women attending their first antenatal care visit; Women with antiretroviral drugs eligibility; HIV-infected women conceiving while on ART continued their current regimen throughout pregnancy; regimens included PIs or NNRTIs; live singleton birth | Women not eligible for antiretroviral drugs at their first ANC visit (receiving zidovudine prophylaxis) | NA | 8/9 |
Phiri et al. (2015) [37] | United States | 1994–2009 | National cohort (from TennCare) | Pregnant women enrolled in Tennessee Medicaid (TennCare); evidence of HIV infection; singleton live birth enrolled in Medicaid | Not mentioned | NA | 6/9 |
Brogly et al. (2010) [38] | United states | 1993–2000 | Multi-site cohort | Children born to HIV-infected women and enrolled before one year of age | Not mentioned | NA | 7/9 |
Prieto et al. (2014) [39] | Spain | 2000–2009 | Multi-site prospective cohort | HIV-infected mother-infants pairs with a definitive outcome through December 31, 2009 | Stillbirth, termination of pregnancy, minor congenital anomalies | NA | 7/9 |
Floridia et al. (2013) [40] | Italy | 2001–2011 | Prospective national cohort | Pregnant women with HIV, in routine clinical care, exposed to ARV | Miscarriage, voluntary termination of pregnancy for psychosocial reasons, and late HIV diagnosis (no ARV treatment before delivery or maternal diagnosis of HIV after delivery) | NA | 5/9 |
van der Merwe et al. (2011) [41] | South Africa | 2004—2007 | Retrospective multi-site cohort | HIV pregnant women attending in clinics of the study; Singleton pregnancy; Women with CD4 count ≤ 250cells/mm3 | Not have given consent | NA | 5/9 |
Watts et al. (2013) [18] | United States | 2007—2010 | Prospective multi-site cohort | Pregnant women; Singleton pregnancy | No information about antiretroviral combination, obstetric data or gestational age | NA | 6/9 |
Zash et al (2017) [42] | Botswana | 2014—2016 | Prospective multi-site cohort | Live birth or stillbirth in women who delivered at government maternity wards in Botswana | Births that occurred before arrival at the hospital or before 24 weeks | NA | 7/9 |
Williams et al. (2015) [43] | United States | 2007–2012 | Prospective multi-site cohort | HIV-infected pregnant women and their children enrolled in the SMARTT study; documented antiretroviral drugs during pregnancy and pregnancy outcome | Not mentioned | NA | 7/9 |
Schulte et al. (2007) [10] | United States | 1989—2004 | Prospective multi-site cohort (PSD) | Information about birth weight, gestational age and HIV status in the 30 first day of life | Not mentioned | NA | 5/9 |
Patel et al (2005) [44] | Europe | 1986—2003 | Prospective multi-site cohort (ECS) | Not mentioned | Not mentioned | NA | 5/9 |
Hu et al. (2019) [45] | China | 2009–2018 | Prospective single-site cohort | Pregnant women HIV-infected, exposed to antiretroviral drugs, reported to the IPMTCT system | HIV-infected pregnant women who elected to terminate their pregnancy | NA | 7/9 |
Grosch-Woerner et al. (2008) [46] | Germany, Austria | 1995—2001 | Prospective multi-site cohort | HIV pregnant women identified from one center in Germany or Austria between 1995 and 2011 | No information about antiretroviral exposure | NA | 6/9 |
Cotter et al. (2006) [47] | United States | 1990—2002 | Prospective multi-site cohort | Singleton pregnancy; Women who received prenatal care in the hospital | Not mentioned | NA | 4/9 |
Carceller et al. (2009) [48] | Canada | 1997—2005 | Retrospective single-site cohort | HIV pregnant women who received HAART; Women who received prenatal care and delivered in Sainte-Justine hospital | Women who did not received HAART; Women who received only one or two antiretroviral drugs | NA | 4/9 |
Natureeba et al. (2014) [49] | Uganda | 2009–2013 | Open-label, single-site, randomized controlled trial | Women ≥ 16 years, infected with HIV-1 at any CD4 cell count, lived within 30 km of the study site, and had a pregnancy between 12–28 weeks gestation | Women who had ever received highly active combination ART or single dose nevirapine or other abbreviated monotherapy or dual therapy in the last 24 months; Women who had prior dose-limited toxicity to TMP-SMX within 14 days, active tuberculosis or other WHO stage 4 diseases, cardiac disease, or abnormal screening laboratory values including, hemoglobin 225 U/L, AST > 225 U/L, total bilirubin ≥ 2.5 times the upper limit of normal, and creatinine ≥ 1.8 times the upper limit of normal | 3/5 | - |
Szyld et al (2006) [50] | Argentina, Bahamas, Brazil, Mexico | 2002—2005 | Prospective multi-site cohort (NISDI) | First enrolment in NISDI of HIV pregnant women; Women who received at least antiretroviral drugs for 28 days during pregnancy; Live and singleton birth; Information about birth weight and gestational age before 1 March 2005 | Women who were still pregnant on 01 March 2005; Stillbirth; Miscarriage | NA | 6/9 |
Joao et al (2010) [51] | Argentina, Brazil | 2002—2007 | Prospective multi-site cohort | Women enrolled in the NISDI for the first time; Singleton infant ≥ 20 weeks (live birth or stillbirth) | No follow-up during pregnancy; Second enrolment; No singleton pregnancy | NA | 6/9 |
EPPICC Study Group (2019) [52] | East and West Europe | 2008—2014 | Multi-site cohort (EPPICC) | Singleton live-birth; No antiretroviral exposure before pregnancy; Antiretroviral exposure during pregnancy (only one antiretroviral combination) | Antiretroviral exposure < 2 weeks; Interruption or change of antiretroviral combination; No information about gestational age | NA | 6/9 |
Snijdewind et al. (2018) [53] | Netherlands | 1997—2015 | Retrospective multi-site cohort (ATHENA) | Singleton live-born ≥ 24 weeks; Women who received antiretroviral combination (at least three drugs) and prenatal care in one of 26 centers in the Netherlands | Stillbirth; Miscarriage; Induced abortion; No information about pregnancy outcome | NA | 5/9 |
Kreitchmann et al. (2014) [54] | Latin America, Caribbean | 2002—2012 | Prospective multi-site cohort | HIV pregnant women; First enrolment in the study | Not mentioned | NA | 5/9 |
Floridia et al. (2020) [55] | Italy | 2001–2011 | Prospective national cohort | Live birth with documented outcome; date of last menstrual period after January 1 2008; use in pregnancy of three-drug regimens composed of a NRTI backbone plus a PI, a NNRTI or an ISTI | No treatment; monotherapy or dual therapy during pregnancy; triple NRTI regimens; switching to a different drug class during pregnancy; concomitant use of two classes among PI, NNRTI, and ISTI; start of antiretroviral treatment after 32 weeks of gestation; use of zidovudine, didanosine, stavudine, saquinavir, amprenavir, nelfinavir or tipranavir | NA | 8/9 |
Ejigu et al. (2019) [56] | Ethiopia | 2010–2016 | Retrospective multi-site cohort | Antiretroviral exposed pregnancies; women attending prenatal care follow-up | Missing information about ART regimen, gestational age at birth and birth weight; ART regimen changed during pregnancy; exposure to ART for less than 2 weeks; abortions or multiple births | NA | 7/9 |
Machado et al. (2008) [57] | Brazil | 1996—2006 | Prospective single-site cohort | HIV pregnant women | Miscarriage | NA | 5/9 |
Stringer et al. (2018) [58] | Botswana, Kenya, Malawi, South Africa, Uganda, Zambia, Zimbabwe, Brazil, Haiti, India, Peru, Thailand, United States | 2005–2015 | Cohort based on three randomized clinical trials | Women included in three randomized clinical trials of HIV prevention or treatment conducted by the US National Institutes of Health, Division of AIDS Clinical Trials Networks, and the National Institute of Allergy and Infectious Diseases in resource-limited settings; Women with documented last menstrual period and pregnancy outcome; antiretroviral drugs exposure prior to conception; singleton birth | Not mentioned | NA | 6/9 |
Patel et al (2010) [59] | United States, Puerto Rico | 2002—2008 | Prospective multi-site cohort | HIV pregnant women who were ≥ 13 years old; Singleton pregnancy; First enrolment in the study; Women with estimated date of conception at least 10 months before 5 March 2008; Women with at least one CD4 + count obtained during pregnancy; Women who did not received antiretroviral drugs at conception or within 6 months prior to conception | No exposure to antiretroviral combination during pregnancy | NA | 7/9 |
Favarato et al. (2018) [60] | UK, Ireland | 2007–2015 | Prospective multi-site cohort (NSHPC) | Pregnancies with documented gestational age resulting in a singleton live birth; women diagnosed with HIV before delivery and reported to the NSHPC by March 2016 | Not mentioned | NA | 7/9 |
Aaron et al. (2012) [61] | United States | 2000–2011 | Prospective single-site cohort | HIV pregnant women aged 17 and more; First pregnancy and first infant delivered in twin gestations | Abortion or miscarriage; switched prenatal providers; incarceration during the index pregnancy | NA | 8/9 |
Favarato et al. (2019) [62] | UK, Ireland | 2007–2015 | Prospective multi-site cohort (NSHPC) | Pregnancies in HIV women resulting in a live birth or stillbirth at ≥ 24-week gestation reported in NSHPC by March 2017 | Not mentioned | NA | 7/9 |
Bellón Cano et al. (2004) [63] | Spain | 1997—2000 | Prospective multi-site cohort | HIV pregnant women who received antiretroviral combination during pregnancy | Not mentioned | NA | 5/9 |