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Sharply increasing maternal mortality rates in some African countries during the 1980s and 1990s coincided with the rise of the HIV epidemic, supporting the logical assumption that HIV infection contributes to maternal mortality. Still, the data needed to prove this assumption have been difficult to come by.
Researchers pooled longitudinal data from six long-term, independent, community-based studies in eastern and southern Africa involving a total of almost 140,000 women, about 50,000 of whom became pregnant at least once during the study period (1989–2012). HIV status was known in slightly more than half the pregnancies. Fertility was substantially lower among HIV-infected women than among women known to be uninfected, and pregnancy-relate…