Meet the CIPHER grantees
||Mary-Ann Davies, University of Cape Town
Amy Slogrove has an MBChB from the University of KwaZulu-Natal, Durban, and is specialized in paediatrics. She holds a PhD and has recently completed a postdoctoral fellowship at the University of Cape Town through the IAS-CIPHER Cohort Collaboration.
More information on Amy | Email
"This investment in comprehensive maternal and birth data for an entire two-year birth cohort will lay the foundation for future assessment of additional medium- and long-term outcomes related to HIV-exposed uninfected infants, as well as child health in general.”
Research project: Does initiation of antiretroviral therapy prior to immune suppression protect against maternal hypertensive disorders in pregnancy and associated adverse birth outcomes in women living with HIV?
Both advanced maternal HIV disease and combination ART during pregnancy are associated with adverse birth outcomes, including preterm delivery, small for gestational age and low birth weight. Also, pregnant women living with HIV conceiving on ART may have a greater probability of hypertensive disorders in pregnancy (gestational hypertension and pre-eclampsia/eclampsia).
The CIPHER project
Dr Slogrove hypothesizes that in the context of universal ART, ART initiation prior to development of severe immune-suppression protects against hypertensive disorders in pregnancy (HDP) and adverse maternal and birth outcomes. Her study will determine:
- Whether maternal HIV and timing of ART initiation are associated with HDP
- The effect of HDP in women living with HIV on adverse maternal and birth outcomes and whether HIV and HDP interact to increase the probability of these adverse outcomes.
This study uses a novel province-wide surveillance system in South Africa’s Western Cape. It uses unique patient identifiers to integrate multiple existing electronic databases for HIV, ART, laboratory, hospital administration and maternal and child health programmes. A pregnancy and birth database has been established, including all pregnant women living with HIV (N≈18,000) and HIV-uninfected (N≈77,000) pregnant women in the province. It also uses two sentinel sites to collect additional maternal data on gestational age, smoking and alcohol use. This study will rapidly determine in an entire population whether widely used ART regimens are associated with HDP and whether this represents a pathway to adverse maternal and birth outcomes.
The US National Institutes of Health has awarded K-43 funding that allows extension of this project to include an additional year of data collection (2019) and to evaluate outcomes until one year of age instead of only at birth, as initially planned in the CIPHER grant proposal.
The CIPHER funding is enabling establishment of a research team to collect enhanced provincial maternal and child health data. Without this funding, the additional human resources required for this would not have been available.