Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV

Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV Olufemi Samuel Amoo, Joy Isioma Oraegbu, Tochukwu Ifeanyi Onuigbo, and 13 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8524249/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background : Although rotavirus infection in pregnancy is generally considered self-limiting, maternal dehydration and systemic inflammatory responses may adversely affect pregnancy outcomes. However, the potential modifying effect of maternal HIV status remains poorly understood. This study examined the prevalence of rotavirus infection and its relationship to adverse pregnancy outcomes among women living with and without HIV. Methods : We conducted a cross-sectional study of 100 pregnant women (50 women with HIV (WWH) and 50 women without HIV(WWoH) attending a public tertiary hospital in Lagos, Nigeria. Stool samples were tested for rotavirus by PCR. HIV status was confirmed using the Nigerian HIV testing algorithm and used to categorize associations with pregnancy outcomes, including low birthweight (LBW), preterm birth, and stillbirth. Results : Overall rotavirus prevalence was 5%, with a higher prevalence in WWoH (8%) compared to WWH (2%). Of the five rotavirus-positive participants, two had Group B rotavirus, 3 had Group C rotavirus, and one was positive for both Group B and Group C. Similarly, the distribution of pregnancy outcomes among the rotavirus-positive participants shows that four had normal pregnancy outcomes, and one had adverse pregnancy outcomes. In contrast, adverse outcomes, including low birthweight (n=6) and combined low birthweight with preterm birth (n=8), occurred exclusively among rotavirus-negative women. Further analysis shows that no stillbirths were associated with rotavirus infection. Additionally, among rotavirus-positive participants, four WWH had normal pregnancy outcomes, whereas one WWoH had an adverse outcome, specifically low birth weight. Conclusion: Rotavirus infection was more frequently detected among WWH than among WWoH. The absence of a consistent association between maternal rotavirus infection and low birth weight, preterm birth, or stillbirth suggests that rotavirus infection during pregnancy did not meaningfully contribute to adverse outcomes in this cohort. Therefore, further studies with larger sample sizes are needed to validate these findings. Rotavirus infection Pregnancy outcomes Maternal HIV infection Sub-Saharan Africa Nigeria BACKGROUND Rotaviruses are the leading cause of acute viral gastroenteritis in infants, accounting annually for approximately 453,000 deaths globally (Njifon et al ., 2024). Rotaviruses contribute to 19.1% of diarrhoea-related mortality in children worldwide (Laker et al ., 2024). Nigeria has one of the highest prevalences of rotavirus disease among children under 5 years of age in Africa, estimated at approximately 56%, and with high mortality rates in children (Ojobor et al ., 2020; Digwo et al ., 2023). However, rotavirus infection is less common among adult Nigerians, with a prevalence of 30.8%, although the most recent report dates to nearly 3 decades ago (Omoigberale & Abiodun, 1996). In adults, infection typically presents with milder symptoms or is asymptomatic compared to infections in children (Anderson & Weber, 2004; Akinola et al ., 2020). This reduced disease severity has been attributed to rotavirus immunity acquired from childhood infections. However, adults with weakened immune systems, such as people with HIV (PWH), caregivers of infected children, or travellers to affected areas, are at higher risk (Anderson & Weber, 2004; Crawford et al ., 2017; CDC, 2024). Rotaviruses are named for their distinctive “wheel-shaped” appearance under electron microscopy (Nirmal & Ganger, 2023). Classified within the Reoviridae family, rotaviruses are double-stranded RNA viruses consisting of more than seven serogroups (A–G, or A-J), of which groups A to C infect humans (Lestari et al ., 2020; Althof et al ., 2023). Group A rotavirus accounts for over 90% of human infections and is distributed worldwide (Crawford et al ., 2017). Their genome comprises 11 segments of double-stranded RNA encoding six structural (VP1–VP4, VP6, VP7) and six non-structural (NSP1–NSP6) proteins (Khakha et al ., 2023). The NSP3 gene (segment 7), with its highly conserved sequence, serves as a reliable target for molecular detection of rotavirus A (Hu et al ., 2012). Rotavirus is highly contagious and primarily transmitted via the faecal-oral route, though direct person-to-person contact has also been documented (Anderson & Weber, 2004; Zaib et al ., 2023). Transmission occurs via environmental reservoirs, including contaminated fluids, food, fingers, and fomites (Julian, 2016; LeClair & McConell, 2025). Infection localises mainly to the intestinal mucosa, with viral replication reported at distal sites, such as the lamina propria and regional lymphatics, particularly in immunocompromised individuals (Schultz et al ., 2022). After ingestion, rotavirus targets mature, non-dividing absorptive villous epithelial cells in the upper two-thirds of the small intestine (Saxena et al ., 2015). Rotavirus is known to damage intestinal epithelial cells and disrupt tight junctions, thereby increasing gut permeability (Jacobi et al ., 2013). This may allow inflammatory mediators to penetrate and upregulate gut immunity (including Th17 cells when specific bacterial species are present), thereby driving increased bone resorption (Barbara et al ., 2021). In pregnancy, high oestrogen protects the skeleton, and a postpartum oestrogen decline leads to increased bone resorption; teleologically, this may be to fortify the milk with calcium (Winter et al., 2020; Nishiura et al., 2025). Its triple-layered capsid provides virion stability, allowing survival through the gastrointestinal tract (Sadiq et al ., 2018). Viral attachment involves capsid protein VP4 and its VP8 domain binding to host enterocytes (Shakya et al ., 2022). Replication in mature enterocytes and intestinal endocrine cells damages villi, reducing absorptive surface area and causing malabsorption (Zaib et al ., 2023). Resulting in ion imbalances that lead to secretory diarrhoea (Shakya et al ., 2022). Clinical signs include watery diarrhoea, vomiting, and fever, though fever is reported in only about 33% of cases (Shakya et al ., 2022). Acute gastroenteritis is relatively common during pregnancy, with prevalence estimates ranging from 3.5% to 5% (Inal et al ., 2018). Symptoms typical of pregnancy, such as nausea and vomiting, may mask underlying infectious causes (Inal et al ., 2018). While bacterial pathogens (e.g., Escherichia coli , Shigella , Salmonella , Campylobacter , Vibrio , and Listeria monocytogenes ) are the predominant causes of gastroenteritis in pregnancy, viral agents, including rotavirus, have also been implicated (Inal et al ., 2018). Despite rotavirus being a well-recognised cause of severe gastroenteritis in children, its prevalence and clinical significance during pregnancy remain poorly defined. Gastroenteritis during pregnancy has been linked to adverse outcomes, including preterm labour, low birthweight, and stillbirth (Conde-Agudelo et al ., 2008; Mehta et al ., 2017). Unlike the high infection rates in children, rotavirus infections in pregnant women are less studied. Available data suggest rotavirus and norovirus can cause gastroenteritis in pregnant adults; however, infections are generally milder in adults unless severe dehydration or high fever occurs (Stuempfig et al ., 2025). The primary risk to pregnancy stems from maternal illness severity rather than direct placental transmission of the virus. Symptoms in adults are often milder than in children; however, diarrhoea, nausea, vomiting, and fever can still occur (Gotfried, 2025). The greatest danger is severe dehydration resulting from persistent symptoms such as vomiting and diarrhoea (Pawłuszkiewicz et al ., 2025). Milder infections last less than 48 hours, and foetal harm is unlikely. However, severe dehydration or high, sustained fever during any trimester may increase the risk of preterm birth and low birthweight (Inal et al ., 2018). During the second trimester, dehydration can contribute to foetal growth restriction, and in the third trimester, it may lead to preterm labour and miscarriage (Mulyani et al ., 2021; Ritter & Sanchez, 2022). Specific data on rotavirus infection and outcomes in pregnant Women with HIV (WWH) are sparse. HIV infection during pregnancy is associated with chronic inflammation and adverse outcomes such as low birthweight and preterm delivery, which may exacerbate complications caused by infections (Yang et al ., 2019; Fleșeriu et al ., 2024). Although rotavirus and HIV frequently coexist in African children, rotavirus infection severity does not appear to be increased in WWH compared to Women without HIV (WWoH) children (Oshitani et al ., 1994; Cunliffe et al ., 2001). However, HIV independently raises morbidity and mortality risk. Natural rotavirus infection severity in HIV-infected children is similar to that of non-HIV children, though prolonged viral shedding and altered immune responses occur (Cunliffe et al ., 2001). Given rotavirus’s established role in paediatric morbidity and mortality, particularly among children born to WWH, the impact of rotavirus infection among WWH warrants further investigation. Understanding this burden is crucial because it may have significant implications for maternal and foetal health. This study investigated the prevalence of rotavirus infection among pregnant women, with and without HIV, and evaluated associated pregnancy outcomes. METHOD This cross-sectional study involved pregnant women, both WWH and WWoH, and was conducted by the Blood and Genetics and Transfusion Research Group, Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research (NIMR). The participants, comprising 50 pregnant WWH and 50 pregnant WWoH who met the following inclusion criteria, were recruited for the study: ( 1 ) WWH pregnant women, 18 years of age and above, with at least 20 weeks of gestation. ( 2 ) WWoH pregnant women, 18 years of age and above, of at least 20 weeks of gestation. ( 3 ) Able to give informed consent ( 4 ) Willing to be followed up together with the infant after birth ( 5 ) Willing to provide the required specimens. Participants excluded were: ( 1 ) Pregnant women who fail to meet any of the inclusion criteria or decline consent to participate. The sample size was determined using; Where: n = minimum required sample size per group Zα/2 = Z-value for 95% confidence level (1.96) Zβ = Z-value for 80% power (0.84) P1 and P2 = expected proportions of adverse pregnancy outcomes or key gut microbiota diversity indicators in WWH and WWoH, respectively. The proportions were assumed to be p1 = 0.40 and p2 = 0.70. Using these assumptions, the sample size calculation yielded: resulting in approximately 40 participants per group. To account for potential data loss and enhance statistical power, a sample size of 50 pregnant women per group (a total of 100) was selected. The participants were recruited from May 2023 to February 2024 from the Federal Medical Centre, Ebute Metta, Lagos, Lagos University Teaching Hospital, Idi-Araba, Lagos, and the Nigerian Institute of Medical Research, NIMR, Yaba, Lagos, outpatient clinics. Fresh Faecal samples were collected using the OMNIgeneGUT|OM-200 (DNA Genotech Inc., Ottawa, Canada) self-collection kit on the morning of the second visit, submitted (2-week interval) from WWH and WWoH, and transported to the laboratory in a cold chain within 6 hours of collection, where they were stored at -80°C. The faecal samples were then analysed using molecular techniques. Briefly, viral RNA was extracted using the RUNMEI viral nucleic extraction kit according to the kit manufacturer’s protocol. Rotavirus groups A, B, and C were detected using the RUN MEI Rotavirus Triple Nucleic acid detection kit. 5 µL of nucleic acid sample was analysed using quantitative PCR on a BIO-RAD system with the FAM (type A), ROX (type B), and HEX (type C) channels. Samples with a CT value less than or equal to 32 were classified as positive, while those with no CT values or a CT value above 38 were classified as negative for each channel. CT values between 33 and 37 were considered inconclusive, and the samples were rerun to obtain a more accurate assessment. Pregnancy outcomes were obtained postpartum from participants' delivery records. The data was analysed using SPSS 26.0 and Microsoft Office Excel 2019. Statistical tools such as Descriptive statistics (frequencies, cross-tabulations, and chi-square tests) were used to generate the results. The results are presented as frequencies (percentages), medians, and interquartile ranges. RESULTS Socio-Demographic and Clinical Symptoms of Study Participants Stratified by HIV Status The socio-demographic characteristics of the study participants are shown in Table 1 . No significant differences in age distribution, marital status, occupation, or geographical zone were observed between WWH and WWoH. However, educational status differed significantly, with more WWoH women having attained tertiary education. Partner HIV status also showed a significant difference, with 26% of partners of WWH also having HIV, compared to none among WWoH. For symptoms and complaints during pregnancy, vaginal discharge was more frequently reported by pregnant WWH, approaching statistical significance. In Table 2 , the median age of WWH was 36 years (IQR: 31–40) and was statistically significantly higher than the median age of 33 years (IQR: 28–37) in WWoH (p = 0.031). Maternal weight was also significantly greater among WWH, with a median of 84 kg (IQR: 84–88), compared to 74 kg (IQR: 62–83) in WWoH (p = 0.040). Height did not differ significantly between groups (p = 0.071). Symphysis fundal height (SFH) was significantly higher in WWH, with a median of 22 cm (IQR: 20–25), versus 20.44 cm (IQR: 18.33–24.80) in WWoH (p < 0.001). Temperature and respiratory rate were also significantly elevated in both groups (p < 0.001 for both). Pulse rate and systolic blood pressure showed no significant differences, while diastolic blood pressure was significantly lower in WWH (p = 0.009). There were no significant differences in gestational age at visit or delivery between the groups. However, infant birth weight was significantly lower among WWH, with a median of 2.8 kg (IQR: 2.3–3.2) compared with 3.2 kg (IQR: 2.7–3.5) in the WWoH group (p = 0.035). Table 1 Socio-demographic Characteristics and Clinical Symptoms of Study Participants Stratified by HIV Status VARI VARIABLES PARTICIPANTS, N = 100 WWH: N = 50 FREQUENCY (%) WWoH: N = 50 FREQUENCY (%) χ² P-VALUE Socio-demographic variables Age 2.988 0.224 20–34 (Optimal Reproductive Age) 23(42.6%) 31 (57.4%) 35–39 (Advanced Maternal Age 1) 13(54.2%) 11 (45.8%) 40+ (Age Maternal Age 2) 14(63.6%) 8(36.4%) Educational Status 6.179 0.046 Primary 3(6%) 1(2%) Secondary 16(32%) 7(14%) Tertiary 31(62%) 42(84%) Occupation Healthcare and Allied Professionals 1(2%) 3(6%) 9.062 0.107 Office-Based Professional (non-Health) 6(12%) 13(26%) Traders and Small Business Owners 35(70%) 23(46%) Skilled and Unskilled Labour 7(14%) 7(14%) Students 0(0%) 3(6%) Unemployed 1(2%) 1(2%) Marital Status Divorced 1(2%) 0(0%) 1.010 0.603 Married 48(96%) 49(98%) Single 1(2%) 1(2%) Geographical Zone North Central 7(14.0%) 11(22%) 2.646 0.619 North West 0(0.0%) 1(2%) South East 18(36.0%) 18(36%) South South 6(12.0%) 6(12%) South West 19(38.0%) 14(28%) ROTAVIRUS STATUS Positive 1 (2%) 4 (8%) 5 (5%) 1.895 0.169 Negative 49 (98%) 46 (92%) 95 (95%) Partner's HIV Serostatus Positive (HIV-1) 13 (26.0%) 0 (0%) 13 (13%) 4.943 < 0.001 Negative 37 (74.0%) 50 (100%) 87 (87%) Symptoms/ Complaints Experienced During Pregnancy Weight loss No 49(98%) 50(100%) 1.010 0.315 Yes 1(2%) 0(0%) Diarrhoea No 49(98%) 49(98%) 0.000 1.000 Yes 1(2%) 1(2%) Chest Pains No 48(96%) 50(100%) 1.010 0.315 Yes 2(4%) 0(0%) Odynophagia No 49(98%) 50(100%) 1.050 0.305 Yes 1(2%) 0(0%) Fever No 48(96%) 48(96%) 0.000 1.000 Yes 2(4%) 2(2%) Abdominal Pain No 48(96%) 48(96%) 0.000 1.000 Yes 2(4%) 2(4%) Vaginal Discharge No 44(88%) 49(98%) 3.840 0.050 Yes 6(12%) 1(2%) Loss of Appetite No 49(98%) 48(96%) 0.344 0.558 Yes 1(2%) 2(4%) Persistent Vomiting No 48(96.0%) 50(100%) 2.041 0.153 Yes 2(4.0%) 0(0%) Shortness of Breadth No 49(98%) 50(100%) 1.010 0.315 Yes 1(2%) 0(0%) Skin Rash No 49(98%) 50(100%) 1.010 0.315 Yes 1(2%) 0(0%) Others (Body/waist pain) Yes 0(0%) 1(2%) 1.010 0.315 No 50(100%) 49(98%) Table 2 Clinical Data of Study Participants Stratified by HIV Status VARIABLES PARTICIPANTS, N = 100 WWH: N = 50 WWoH: N = 50 MEDIAN (IQR) MEDIAN (IQR) χ² P-VALUE Age (years) 36 ( 31 – 40 ) 33 ( 28 – 37 ) 39.739 0.031 Maternal Anthropometric and Vital Signs Weight (kg) 84 (84–88) 74 (62–83) 67.619 0.040 Height (cm) (149). (120–160) 166 (160–168) 43.252 0.071 SFH (Symphysis Fundal Height-cm) 22 ( 20 – 25 ) 20.44 (18.33–24.80) 35.463 0.000 Temperature(ºC) 36.5 (36.4–36.7) 36.0 (35.5–36.0) 45.922 0.000 Respiratory rate (cycles/min) 20 ( 18 – 20 ) 18 ( 18 – 20 ) 51.426 < 0.001 Pulse (beats/min) 94 (85–98) 95(85–100) 44.095 0.383 BP (mm/Hg) Systolic 111.53 112.50 42.613 0.176 Diastolic 65.14 72.67 46.229 0.009 CD4 < 350 10 1 8.274 0.004 ≥ 350 40 49 Pregnancy and Delivery Characteristics Gestational Age at Visit (weeks) 24( 21 – 25 ) 22( 21 – 26 ) 12.579 0.400 Gestational Age at Delivery (weeks) 37 ( 37 – 38 ) 38 ( 37 – 38 ) 14.873 0.188 Infant weight (kg) 2.8(2.3–3.2) 3.2 (2.7–3.5) 52.835 0.035 Distribution of Rotavirus Groups (A, B, C) among Study Participants by HIV Status Table 3 summarises the distribution of rotavirus group-specific detections among pregnant women in the study population. Although the overall rotavirus-positive count was five based on the non-group-specific assay, group-level analysis identified six group-specific detections because one participant tested positive for both Rotavirus Group B and Group C. This dual positivity accounts for the numerical discrepancy between the total rotavirus-positive count and the sum of group-specific detections. Table 3 Prevalence of Rotavirus Groups B and C With Identification of Dual Positivity Among Study Participants Stratified by HIV Status and Adjusted for Co-classification Rotavirus Group WWoH (n = 50) WWH (n = 50) Total Detections Notes Group A 0 0 0 No detection Group B 2 0 2 One participant was co-positive with Group C Group C 3 1 4 Includes the co-positive individual Unique Rotavirus-Positive Individuals — — 5 Total unique cases (non-group-specific assay) Association of Rotavirus Groups with Pregnancy Outcomes of all study participants Table 4 presents the association between Rotavirus groups (A, B, and C) and pregnancy outcomes among all study participants. No positive cases of Rotavirus Group A were detected; therefore, all participants were negative, with 79 experiencing expected pregnancy outcomes and 21 reporting adverse outcomes. For Rotavirus Group B, 2 participants tested positive, and both had normal pregnancy outcomes. Among participants who were negative for Group B, 77 had expected outcomes while 21 had adverse outcomes. This association was not statistically significant (χ² = 0.542, p = 0.461). Similarly, for Rotavirus Group C, 3 participants tested positive; one of these experienced an adverse pregnancy outcome, while the remaining had expected outcomes. Among Group C-negative participants, 76 had normal outcomes, and 20 had adverse outcomes, with no significant association observed (χ² = 0.040, p = 0.841). Analysis of the association between all rotavirus groups and pregnancy outcomes showed no significant association (χ² = 0.003, p = 0.955). Among women with rotavirus positivity, 4 had normal birth outcomes, whereas 1 experienced an adverse outcome. Similarly, 75 of the rotavirus-negative women had normal outcomes, and 20 had adverse outcomes, indicating no significant difference between the two groups. The relationship between rotavirus infection and specific birth outcomes was not statistically significant (χ² = 2.008, p = 0.848). Among rotavirus-positive women, 4 had normal birth outcomes, whereas one experienced low birth weight (LBW). In contrast, among rotavirus-negative women, 75 had normal outcomes, and 20 (19.8%) had various adverse outcomes, including LBW, preterm birth (PTB), and stillbirth. The distribution of specific adverse birth outcomes, including low birthweight (LBW), preterm birth (PTB), and stillbirth, across the different Rotavirus groups is illustrated in Table 4 c. Table 4 a : Association between Rotavirus Groups in Relation to Pregnancy Outcomes among Study Participants ROTAVIRUS PREGNANCY OUTCOMES χ² P-VALUE ROTAVIRUS GROUP A NORMAL ADVERSE POSITIVE - - - - NEGATIVE 79 21 ROTAVIRUS GROUP B POSITIVE 2 0 0.542 0.461 NEGATIVE 77 21 ROTAVIRUS GROUP C POSITIVE 3 1 0.040 0.841 NEGATIVE 76 20 Table 4 b: Association between Rotavirus in Relation to Pregnancy Outcomes among Study Participants ROTAVIRUS (All groups) BIRTH OUTCOMES N = 100 χ² P-VALUE NORMAL (%) ADVERSE (%) POSITIVE 4 (4%) 1 (1%) 0.003 0.955 NEGATIVE 75 (75%) 20 (20%) Table 4 c: Association between Rotavirus in Relation to Specific Pregnancy Outcomes among Study Participants ROTAVIRUS (All groups) BIRTH OUTCOMES χ² P-VALUE NORMAL (%) ADVERSE LBW (%) LBW, PTB (%) LBW, STILLBIRTH, PTB (%) PTB (%) STILL BIRTH (%) POSITIVE 4 (80%) 1(20%) 0 0 0 0 2.008 0.848 NEGATIVE 75 6 8 2 3 1 Association of Rotavirus Groups and Pregnancy Outcomes among Study Participants by HIV Status Table 5 shows pregnancy outcomes categorised as normal or adverse among women living with HIV and WWoH women, stratified by rotavirus group (A, B, and C) status and presence. Across all groups, the majority of women had normal pregnancy outcomes regardless of HIV status or rotavirus detection. For Rotavirus Group A, all rotavirus tests were negative in both WWH and WWoH; therefore, statistical analysis was not performed. In Groups B and C, rotavirus was detected in a small minority of WWoH (Group B: 2 positives; Group C: 3 positives) and in very few WWH (Group C: 1 positive). The chi-square (χ²) values and associated p-values across these comparisons (Group B: χ²=0.284, p = 0.594; Group C: χ²=0.437 and 1.375, p = 0.508 and 0.241) indicate no statistically significant associations between rotavirus presence, HIV status, and adverse pregnancy outcomes in this sample. The distribution of Rotavirus and the different adverse birth outcomes, which include Low birthweight (LBW), Pre-term birth (PTB), and Stillbirth, by HIV Status is presented in Table 5 b with no significant difference as well. Table 5 a: Association Between RV Positives by HIV Status and Birth Outcome Groups BIRTH OUTCOME ROTAVIRUS STATUS HIV STATUS Total Χ² P-VALUE WWH (n = 50) WWoH (n = 50) ADVERSE Rotavirus negative 15 5 20 2.625 0.105 positive 0 1 1 NORMAL Rotavirus negative 34 41 75 0.636 0.425 positive 1 3 4 Total Rotavirus negative 49 46 95 positive 1 4 5 Table 5 b: Association Between RV Positives by HIV Status and Specific Adverse Birth Outcomes BIRTH OUTCOME ROTAVIRUS STATUS HIV STATUS Total Χ² P-VALUE WWH (n = 50) WWoH (n = 50) LBW Rotavirus negative 6 0 6 7.000 0.008 positive 0 1 1 LBW, PTB Rotavirus negative 8 0 8 - - LBW, STILL BIRTH, PTB Rotavirus negative 1 1 2 - - NORMAL Rotavirus negative 34 41 75 0.636 0.425 positive 1 3 4 PTB Rotavirus negative 0 3 3 - - STILL BIRTH Rotavirus negative 0 1 1 - - Total Rotavirus negative 49 46 95 positive 1 4 5 Discussion Rotavirus infection is globally recognised as a significant cause of acute gastroenteritis, with Group A being the most commonly reported strain in humans. Although primarily a paediatric disease, rotavirus can also infect adults, including pregnant women, potentially influencing pregnancy outcomes through dehydration, malnutrition, or immune-mediated mechanisms. The situation may be of particular concern in WWH, whose immune suppression could predispose them to more severe or prolonged infections. However, data on rotavirus infection during pregnancy in Nigeria, especially in relation to HIV status, are limited. Most published studies have focused on children under five years of age, leaving an important knowledge gap regarding maternal infection and pregnancy outcomes. To our knowledge, our study is the first to report the prevalence of rotavirus infection and its association with pregnancy outcomes among pregnant women in Nigeria, comparing WWH and WWoH. Although studies specifically assessing active rotavirus infection in pregnancy are rare, evidence indicates that most pregnant women possess antibodies against rotavirus, which are transferred to their infants postpartum (Meier et al ., 2017). Rotavirus Groups A, B, and C are all known to cause gastroenteritis but differ in epidemiology, host susceptibility, and disease severity (Bresee, 2020). In adults, Group A rotavirus infection is usually asymptomatic or causes mild-to-moderate diarrhoea that is often self-limiting (Anderson & Weber, 2004). Group B, while less prevalent, has caused large outbreaks among adults in China and has been detected in other parts of the world (Zhong et al , 1997). Group C rotavirus, though typically associated with milder disease, disproportionately affects older children and adults (Tian et al ., 2024). In our study, five participants tested positive for rotavirus infection. The discrepancy between the overall rotavirus prevalence (five cases) and the six detections observed in the group-specific analysis (Table 3 ) is explained by one participant who tested positive for both Rotavirus Groups B and C. Thus, the group-level assays identified six strain-specific signals; the number of unique infected individuals remained five. Mixed infections of different rotavirus groups are biologically plausible and have been documented in settings with co-circulating strains (Nyaga et al ., 2015). Notably, only Groups B and C were detected; Group A was not identified, suggesting an unusual circulation pattern distinct from regions where Group A is typically dominant. These findings highlight the added value of group-specific typing in revealing infections that non-typing screening assays may underestimate. The absence of Group A detection in this study could be related to the national rotavirus vaccination programme introduced in 2022, which targets Group A strains explicitly and may have contributed to reduced transmission (Oladunni et al ., 2024). Unexpectedly, a higher prevalence of Groups B and C was observed among WWoH compared with WWH, contrary to expectations that immunocompromised individuals, such as WWH, are at increased risk of enteric infections. Similar findings have been reported in other African settings, where rotavirus infection rates were not consistently higher among PWH (Khumalo et al ., 2020). Several plausible explanations may account for this pattern. Firstly, the use of antiretroviral therapy (ART) in WWH may enhance immune reconstitution and gut mucosal defence, thereby reducing susceptibility to or severity of rotavirus infections for pregnant WWH. Secondly, although both WWH and WWoH receive antenatal care, WWH often undergo more frequent medical follow-up and receive targeted counselling on hygiene and infection prevention. This increased contact with healthcare providers may reduce their exposure to contaminated water and food sources. Despite the observed differences in prevalence, no statistically significant association was found between rotavirus infection and adverse pregnancy outcomes in this study. Outcomes, including low birthweight (LBW), preterm birth (PTB), combined LBW and PTB, and stillbirth, were observed among both rotavirus-positive and -negative participants. However, these outcomes occurred more frequently in women who tested negative for rotavirus than in those who tested positive, suggesting that rotavirus infection was not a significant determinant of pregnancy complications in this cohort. This finding aligns with the observations of Inal et al . (2018), who reported no significant association between maternal enteric viral infections, including rotavirus, and adverse pregnancy outcomes in a prospective cohort study. Only one adverse outcome was recorded among Rotavirus Group C positive participants, while none occurred in Group B positive cases. The predominance of expected pregnancy outcomes among women infected with rotavirus suggests that rotavirus infection exerts minimal or no direct effect on foetal development or delivery outcomes. This is consistent with existing evidence showing that rotavirus infection in adults is typically confined to the gastrointestinal tract, with limited potential for systemic dissemination or vertical transmission (Parashar et al ., 2003; Crawford et al ., 2017; Rolfe & Daryaei, 2020). Moreover, most enteric viral infections are self-limiting and rarely lead to adverse obstetric outcomes unless complicated by severe dehydration, fever, or concurrent infections (Crawford et al ., 2017; Stuempfig et al ., 2025); nevertheless, indirect mechanisms cannot be entirely excluded. However, if most infections in this study were mild or subclinical and pre-existing maternal antibodies were present, these factors may have reduced the likelihood of adverse effects, although this could not be directly confirmed in this study (Beltrami et al ., 2023). The significantly higher median age observed among pregnant WWH (36 years) compared with their HIV-seronegative counterparts (33 years) is physiologically relevant because advancing maternal age is independently associated with increased obstetric risks, including low birthweight, preterm birth, and stillbirth (Abebe et al ., 2025). These risks are partly driven by age-related vascular, metabolic, and immunological changes that can affect foetal growth and overall pregnancy stability (Neiger, 2017). Interestingly, despite being older on average, WWH in this study did not experience adverse outcomes in the rotavirus-positive subgroup, whereas all adverse outcomes occurred among younger, WWoH. This pattern suggests that maternal age alone does not account for the distribution of pregnancy outcomes in this cohort. Instead, it highlights the possibility that other factors, such as differential health-seeking behaviour, routine HIV-related clinical monitoring, ART-driven immune stabilisation, or unmeasured sociodemographic variables, may have played a more influential role. These findings underscore the need for larger studies to disentangle the biological and contextual drivers of pregnancy outcomes in mixed HIV-status populations. Another noteworthy observation in this study is the significantly lower infant birthweight among WWH on ART compared with WWoH. This finding aligns with established evidence that HIV infection, even in the era of effective ART, can influence foetal growth through other factors that can lead to pregnancy complications (Fleșeriu et al ., 2024). The lower birth weight observed among WWH, despite the absence of rotavirus-associated adverse outcomes in this group, suggests that underlying HIV-related physiological factors may exert a more consistent impact on fetal growth than acute viral infections such as rotavirus (Muhangi et al ., 2013). When considered alongside the older median age of WWH, this lower birth-weight pattern indicates a multifactorial interplay where maternal age, HIV-associated immune dysregulation, and ART exposure may collectively shape foetal growth trajectories. Importantly, these HIV-related effects appear independent of rotavirus infection, reinforcing the conclusion that rotavirus showed no evidence of a significant role in determining pregnancy outcomes in this cohort. Overall, this study demonstrates that maternal rotavirus infection was uncommon and not associated with adverse pregnancy outcomes. Instead, HIV-related factors, notably lower infant birthweight, remain more clinically relevant. Further research with larger sample sizes is needed to validate these findings and explore the mechanisms by which HIV and its treatment influence foetal growth and maternal susceptibility to Rotavirus infections (Khumalo et al ., 2020). Conclusion In summary, rotavirus infection was uncommon in this cohort of pregnant women. Although a higher proportion of cases occurred among WWoH compared with WWH, this difference was slight, statistically non-significant, and likely incidental. The predominance of Rotavirus Groups B and C, alongside the absence of Group A, suggests possible shifts in circulating strains following the introduction of the Group A targeted vaccine into Nigeria’s national immunisation program. Notably, there was no evidence of increased risk of adverse pregnancy outcomes in WWH due to rotavirus infection, as nearly all complications occurred among WWoH. These findings suggest that, within this population, rotavirus contributes minimally to obstetric risk, whereas HIV-related physiological factors, such as lower infant birthweight, remain more clinically relevant. Larger studies are needed to confirm these observations and to clarify the broader epidemiological relevance of rotavirus infection during pregnancy in Nigeria. Clinical and Epidemiological Implications Rotavirus infection was not significantly associated with adverse pregnancy outcomes in this cohort. Most infected women experienced regular deliveries, suggesting that rotavirus infections during pregnancy are typically mild and self-limiting. The detection of non-Group A strains (Groups B and C) also highlights a noteworthy observation, underscoring the importance of sustained rotavirus surveillance. Public Health Implications This finding of higher rotavirus prevalence among WWoH underscores the complex interplay between host immunity, ART-related immune restoration, and environmental exposure risks. These findings emphasise the need for strengthened antenatal care systems, improved hygiene education, and guaranteed access to safe water and food as key preventive measures to reduce enteric infections in pregnancy among WWoH. Strengths and Limitations A key strength of this study is its focus on rotavirus infection among pregnant women, a population often overlooked in enteric virus research in sub-Saharan Africa. The inclusion of both WWH and WWoH allowed for comparative insights into immune and epidemiological dynamics. Additionally, molecular detection of Rotavirus Groups A, B, and C provides early evidence of shifting strain patterns in the post-vaccine era. However, limitations include a modest sample size, which may reduce statistical power, and a cross-sectional design, which precludes causal inferences. Future Directions Future research employing larger, multicentre cohorts and longitudinal follow-up to assess temporal patterns and causal links between maternal rotavirus infection and pregnancy outcomes is indicated. Incorporating viral quantification and immune profiling will help clarify the roles of gut immunity and environmental factors in rotavirus susceptibility across WWH and HIV-seronegative groups. Such studies are essential to guide vaccine strategy, strengthen maternal infection surveillance, and improve health outcomes for women and infants in endemic, resource-limited regions. Declarations Ethics Approval and Consent to Participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki, and ethical clearance (IRB/22/053) was obtained from the Institutional Review Board of the Nigerian Institute of Medical Research, Yaba, Lagos. Written informed consent was obtained from all participants prior to participation in the study. Consent for publication : Not applicable. The study did not include any individual person’s data in an identifiable form. Availability of Data and Materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interests: The authors declare that they have no competing interests. Funding: This research received no external funding. Authors’ Contributions: OSA designed the study and supervised the research. OJO conducted the study, performed sample collection, laboratory analysis, and drafted the manuscript; TIO performed laboratory analysis and drafted the manuscript, FA performed laboratory analysis and manuscript writing, EUU performed laboratory analysis, and OJ performed laboratory analysis. All authors read and approved the final manuscript. Acknowledgements: The authors acknowledge the clinic staff of the Nigerian Institute of Medical Research, the Federal Medical Centre, and the Lagos University Teaching Hospital, which facilitated access to the samples used in this study. References Abebe YM, Deribe L, Fantahun A, Beyene BN, Megule SM, Shiferaw WG, Adugna KF, Tessema LW, Getu AA, Kassahun EA, Alemayehu BA, Nega AT, Azene Z, Bante SA, Awoke AM, Chekole FA, Balcha WF. 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Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 17 Feb, 2026 Reviewers agreed at journal 15 Feb, 2026 Reviewers invited by journal 05 Feb, 2026 Editor invited by journal 09 Jan, 2026 Editor assigned by journal 07 Jan, 2026 Submission checks completed at journal 07 Jan, 2026 First submitted to journal 05 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8524249","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":587479145,"identity":"15062389-7c8c-4675-a3fa-fe12920deae6","order_by":0,"name":"Olufemi Samuel Amoo","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Olufemi","middleName":"Samuel","lastName":"Amoo","suffix":""},{"id":587479146,"identity":"87b4cfe1-820b-45b0-803d-d4b91a6de8d4","order_by":1,"name":"Joy Isioma Oraegbu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYBACxgYow4CB+QCQkpAhRQtbAkgLD/HWGTDwGIBowlqY23sMH1fU2Nhtl8j5/OpGjQUPA/vhoxvwOqznjLHhmWNpyTtn5G6zzjkGdBhPWtoNvFpm5JhJNrAdTja4kbvNOIcNqEWCx4wILf/+A7XkPDPO+Ueslsa2A3ZALcyPc9uI0dJzrNiwsS85wbLnmRlzbp8EDxshvxi2N2982PDNzt6cPfnx55xvdXL87IeP4dfSwAGOjsQGBgY2CRCLDZ9yEJBnYH8Aou2BmPkDIdWjYBSMglEwMgEAyWpIp/Ux/j4AAAAASUVORK5CYII=","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":true,"prefix":"","firstName":"Joy","middleName":"Isioma","lastName":"Oraegbu","suffix":""},{"id":587479147,"identity":"435a227b-86f6-47f3-9e46-c60c16f7a5b1","order_by":2,"name":"Tochukwu Ifeanyi Onuigbo","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Tochukwu","middleName":"Ifeanyi","lastName":"Onuigbo","suffix":""},{"id":587479148,"identity":"019732ac-9364-4a21-8a8b-b50b752519ae","order_by":3,"name":"Job Adekunle Adebayo","email":"","orcid":"","institution":"Federal Medical Centre Ebute Meta","correspondingAuthor":false,"prefix":"","firstName":"Job","middleName":"Adekunle","lastName":"Adebayo","suffix":""},{"id":587479149,"identity":"229f07b7-c3a2-4478-a30b-a1c3c2a6ce21","order_by":4,"name":"Prisca Obichere","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Prisca","middleName":"","lastName":"Obichere","suffix":""},{"id":587479150,"identity":"b2ebb3e5-5924-4342-938f-f9503436cb85","order_by":5,"name":"Gladys Olohitai Ohiomoba","email":"","orcid":"","institution":"Federal Medical Centre Ebute Meta","correspondingAuthor":false,"prefix":"","firstName":"Gladys","middleName":"Olohitai","lastName":"Ohiomoba","suffix":""},{"id":587479151,"identity":"354ae009-682e-4064-8a27-d4b9babe7056","order_by":6,"name":"Favour Adebowale","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Favour","middleName":"","lastName":"Adebowale","suffix":""},{"id":587479152,"identity":"8821454f-3e48-4ad6-9434-9562f8a72987","order_by":7,"name":"Edikan Usiwomah Umoh","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Edikan","middleName":"Usiwomah","lastName":"Umoh","suffix":""},{"id":587479153,"identity":"f4c2d049-f25a-48dd-a3d1-815416c98a4b","order_by":8,"name":"Oluwafunmilayo Jokotoye","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Oluwafunmilayo","middleName":"","lastName":"Jokotoye","suffix":""},{"id":587479154,"identity":"de365411-a3b6-433d-95d6-53ab2a483dc1","order_by":9,"name":"Tajudeen Akanji Bamidele","email":"","orcid":"","institution":"Lagos University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tajudeen","middleName":"Akanji","lastName":"Bamidele","suffix":""},{"id":587479155,"identity":"266b1733-e4b9-4318-91c4-707865897703","order_by":10,"name":"Sulaimon Alani Akanmu","email":"","orcid":"","institution":"Lagos University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sulaimon","middleName":"Alani","lastName":"Akanmu","suffix":""},{"id":587479156,"identity":"baf5ee20-710f-4f07-937f-2f7ce6a5a78c","order_by":11,"name":"Neale M. 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Audu","email":"","orcid":"","institution":"Nigerian Institute of Medical Research","correspondingAuthor":false,"prefix":"","firstName":"Rosemary","middleName":".A.","lastName":"Audu","suffix":""}],"badges":[],"createdAt":"2026-01-05 18:53:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8524249/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8524249/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102216651,"identity":"0191f4e4-f333-408f-86da-6831d4f4ff74","added_by":"auto","created_at":"2026-02-09 12:58:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1574066,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8524249/v1/5e9f84fa-e049-4d7d-bb87-83b383a06dbd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eRotaviruses are the leading cause of acute viral gastroenteritis in infants, accounting annually for approximately 453,000 deaths globally (Njifon \u003cem\u003eet al\u003c/em\u003e., 2024). Rotaviruses contribute to 19.1% of diarrhoea-related mortality in children worldwide (Laker \u003cem\u003eet al\u003c/em\u003e., 2024). Nigeria has one of the highest prevalences of rotavirus disease among children under 5 years of age in Africa, estimated at approximately 56%, and with high mortality rates in children (Ojobor \u003cem\u003eet al\u003c/em\u003e., 2020; Digwo \u003cem\u003eet al\u003c/em\u003e., 2023). However, rotavirus infection is less common among adult Nigerians, with a prevalence of 30.8%, although the most recent report dates to nearly 3 decades ago (Omoigberale \u0026amp; Abiodun, 1996). In adults, infection typically presents with milder symptoms or is asymptomatic compared to infections in children (Anderson \u0026amp; Weber, 2004; Akinola \u003cem\u003eet al\u003c/em\u003e., 2020). This reduced disease severity has been attributed to rotavirus immunity acquired from childhood infections. However, adults with weakened immune systems, such as people with HIV (PWH), caregivers of infected children, or travellers to affected areas, are at higher risk (Anderson \u0026amp; Weber, 2004; Crawford \u003cem\u003eet al\u003c/em\u003e., 2017; CDC, 2024).\u003c/p\u003e \u003cp\u003eRotaviruses are named for their distinctive \u0026ldquo;wheel-shaped\u0026rdquo; appearance under electron microscopy (Nirmal \u0026amp; Ganger, 2023). Classified within the \u003cem\u003eReoviridae\u003c/em\u003e family, rotaviruses are double-stranded RNA viruses consisting of more than seven serogroups (A\u0026ndash;G, or A-J), of which groups A to C infect humans (Lestari \u003cem\u003eet al\u003c/em\u003e., 2020; Althof \u003cem\u003eet al\u003c/em\u003e., 2023). Group A rotavirus accounts for over 90% of human infections and is distributed worldwide (Crawford \u003cem\u003eet al\u003c/em\u003e., 2017). Their genome comprises 11 segments of double-stranded RNA encoding six structural (VP1\u0026ndash;VP4, VP6, VP7) and six non-structural (NSP1\u0026ndash;NSP6) proteins (Khakha \u003cem\u003eet al\u003c/em\u003e., 2023). The NSP3 gene (segment 7), with its highly conserved sequence, serves as a reliable target for molecular detection of rotavirus A (Hu \u003cem\u003eet al\u003c/em\u003e., 2012).\u003c/p\u003e \u003cp\u003eRotavirus is highly contagious and primarily transmitted via the faecal-oral route, though direct person-to-person contact has also been documented (Anderson \u0026amp; Weber, 2004; Zaib \u003cem\u003eet al\u003c/em\u003e., 2023). Transmission occurs via environmental reservoirs, including contaminated fluids, food, fingers, and fomites (Julian, 2016; LeClair \u0026amp; McConell, 2025). Infection localises mainly to the intestinal mucosa, with viral replication reported at distal sites, such as the lamina propria and regional lymphatics, particularly in immunocompromised individuals (Schultz \u003cem\u003eet al\u003c/em\u003e., 2022). After ingestion, rotavirus targets mature, non-dividing absorptive villous epithelial cells in the upper two-thirds of the small intestine (Saxena \u003cem\u003eet al\u003c/em\u003e., 2015). Rotavirus is known to damage intestinal epithelial cells and disrupt tight junctions, thereby increasing gut permeability (Jacobi \u003cem\u003eet al\u003c/em\u003e., 2013). This may allow inflammatory mediators to penetrate and upregulate gut immunity (including Th17 cells when specific bacterial species are present), thereby driving increased bone resorption (Barbara \u003cem\u003eet al\u003c/em\u003e., 2021). In pregnancy, high oestrogen protects the skeleton, and a postpartum oestrogen decline leads to increased bone resorption; teleologically, this may be to fortify the milk with calcium (Winter et al., 2020; Nishiura et al., 2025). Its triple-layered capsid provides virion stability, allowing survival through the gastrointestinal tract (Sadiq \u003cem\u003eet al\u003c/em\u003e., 2018). Viral attachment involves capsid protein VP4 and its VP8 domain binding to host enterocytes (Shakya \u003cem\u003eet al\u003c/em\u003e., 2022). Replication in mature enterocytes and intestinal endocrine cells damages villi, reducing absorptive surface area and causing malabsorption (Zaib \u003cem\u003eet al\u003c/em\u003e., 2023). Resulting in ion imbalances that lead to secretory diarrhoea (Shakya \u003cem\u003eet al\u003c/em\u003e., 2022). Clinical signs include watery diarrhoea, vomiting, and fever, though fever is reported in only about 33% of cases (Shakya \u003cem\u003eet al\u003c/em\u003e., 2022).\u003c/p\u003e \u003cp\u003eAcute gastroenteritis is relatively common during pregnancy, with prevalence estimates ranging from 3.5% to 5% (Inal \u003cem\u003eet al\u003c/em\u003e., 2018). Symptoms typical of pregnancy, such as nausea and vomiting, may mask underlying infectious causes (Inal \u003cem\u003eet al\u003c/em\u003e., 2018). While bacterial pathogens (e.g., \u003cem\u003eEscherichia coli\u003c/em\u003e, \u003cem\u003eShigella\u003c/em\u003e, \u003cem\u003eSalmonella\u003c/em\u003e, \u003cem\u003eCampylobacter\u003c/em\u003e, \u003cem\u003eVibrio\u003c/em\u003e, and \u003cem\u003eListeria monocytogenes\u003c/em\u003e) are the predominant causes of gastroenteritis in pregnancy, viral agents, including rotavirus, have also been implicated (Inal \u003cem\u003eet al\u003c/em\u003e., 2018).\u003c/p\u003e \u003cp\u003eDespite rotavirus being a well-recognised cause of severe gastroenteritis in children, its prevalence and clinical significance during pregnancy remain poorly defined. Gastroenteritis during pregnancy has been linked to adverse outcomes, including preterm labour, low birthweight, and stillbirth (Conde-Agudelo \u003cem\u003eet al\u003c/em\u003e., 2008; Mehta \u003cem\u003eet al\u003c/em\u003e., 2017). Unlike the high infection rates in children, rotavirus infections in pregnant women are less studied. Available data suggest rotavirus and norovirus can cause gastroenteritis in pregnant adults; however, infections are generally milder in adults unless severe dehydration or high fever occurs (Stuempfig \u003cem\u003eet al\u003c/em\u003e., 2025). The primary risk to pregnancy stems from maternal illness severity rather than direct placental transmission of the virus. Symptoms in adults are often milder than in children; however, diarrhoea, nausea, vomiting, and fever can still occur (Gotfried, 2025). The greatest danger is severe dehydration resulting from persistent symptoms such as vomiting and diarrhoea (Pawłuszkiewicz \u003cem\u003eet al\u003c/em\u003e., 2025).\u003c/p\u003e \u003cp\u003eMilder infections last less than 48 hours, and foetal harm is unlikely. However, severe dehydration or high, sustained fever during any trimester may increase the risk of preterm birth and low birthweight (Inal \u003cem\u003eet al\u003c/em\u003e., 2018). During the second trimester, dehydration can contribute to foetal growth restriction, and in the third trimester, it may lead to preterm labour and miscarriage (Mulyani \u003cem\u003eet al\u003c/em\u003e., 2021; Ritter \u0026amp; Sanchez, 2022).\u003c/p\u003e \u003cp\u003eSpecific data on rotavirus infection and outcomes in pregnant Women with HIV (WWH) are sparse. HIV infection during pregnancy is associated with chronic inflammation and adverse outcomes such as low birthweight and preterm delivery, which may exacerbate complications caused by infections (Yang \u003cem\u003eet al\u003c/em\u003e., 2019; Fleșeriu \u003cem\u003eet al\u003c/em\u003e., 2024). Although rotavirus and HIV frequently coexist in African children, rotavirus infection severity does not appear to be increased in WWH compared to Women without HIV (WWoH) children (Oshitani \u003cem\u003eet al\u003c/em\u003e., 1994; Cunliffe \u003cem\u003eet al\u003c/em\u003e., 2001). However, HIV independently raises morbidity and mortality risk. Natural rotavirus infection severity in HIV-infected children is similar to that of non-HIV children, though prolonged viral shedding and altered immune responses occur (Cunliffe \u003cem\u003eet al\u003c/em\u003e., 2001).\u003c/p\u003e \u003cp\u003eGiven rotavirus\u0026rsquo;s established role in paediatric morbidity and mortality, particularly among children born to WWH, the impact of rotavirus infection among WWH warrants further investigation. Understanding this burden is crucial because it may have significant implications for maternal and foetal health. This study investigated the prevalence of rotavirus infection among pregnant women, with and without HIV, and evaluated associated pregnancy outcomes.\u003c/p\u003e"},{"header":"METHOD","content":"\u003cp\u003eThis cross-sectional study involved pregnant women, both WWH and WWoH, and was conducted by the Blood and Genetics and Transfusion Research Group, Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute of Medical Research (NIMR). The participants, comprising 50 pregnant WWH and 50 pregnant WWoH who met the following inclusion criteria, were recruited for the study: (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e) WWH pregnant women, 18 years of age and above, with at least 20 weeks of gestation. (\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e) WWoH pregnant women, 18 years of age and above, of at least 20 weeks of gestation. (\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e) Able to give informed consent (\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e) Willing to be followed up together with the infant after birth (\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e) Willing to provide the required specimens. Participants excluded were: (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e) Pregnant women who fail to meet any of the inclusion criteria or decline consent to participate. The sample size was determined using;\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\"\u003e\u003c/p\u003e\n\u003cp\u003eWhere:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;minimum required sample size per group\u003c/p\u003e\n\u003cp\u003eZ\u0026alpha;/2\u0026thinsp;=\u0026thinsp;Z-value for 95% confidence level (1.96)\u003c/p\u003e\n\u003cp\u003eZ\u0026beta;\u0026thinsp;=\u0026thinsp;Z-value for 80% power (0.84)\u003c/p\u003e\n\u003cp\u003eP1 and P2\u0026thinsp;=\u0026thinsp;expected proportions of adverse pregnancy outcomes or key gut microbiota diversity indicators in WWH and WWoH, respectively. The proportions were assumed to be p1\u0026thinsp;=\u0026thinsp;0.40 and p2\u0026thinsp;=\u0026thinsp;0.70.\u003c/p\u003e\n\u003cp\u003eUsing these assumptions, the sample size calculation yielded:\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003cp\u003eresulting in approximately 40 participants per group. To account for potential data loss and enhance statistical power, a sample size of 50 pregnant women per group (a total of 100) was selected. The participants were recruited from May 2023 to February 2024 from the Federal Medical Centre, Ebute Metta, Lagos, Lagos University Teaching Hospital, Idi-Araba, Lagos, and the Nigerian Institute of Medical Research, NIMR, Yaba, Lagos, outpatient clinics. Fresh Faecal samples were collected using the OMNIgeneGUT|OM-200 (DNA Genotech Inc., Ottawa, Canada) self-collection kit on the morning of the second visit, submitted (2-week interval) from WWH and WWoH, and transported to the laboratory in a cold chain within 6 hours of collection, where they were stored at -80\u0026deg;C. The faecal samples were then analysed using molecular techniques. Briefly, viral RNA was extracted using the RUNMEI viral nucleic extraction kit according to the kit manufacturer\u0026rsquo;s protocol. Rotavirus groups A, B, and C were detected using the RUN MEI Rotavirus Triple Nucleic acid detection kit. 5 \u0026micro;L of nucleic acid sample was analysed using quantitative PCR on a BIO-RAD system with the FAM (type A), ROX (type B), and HEX (type C) channels. Samples with a CT value less than or equal to 32 were classified as positive, while those with no CT values or a CT value above 38 were classified as negative for each channel. CT values between 33 and 37 were considered inconclusive, and the samples were rerun to obtain a more accurate assessment. Pregnancy outcomes were obtained postpartum from participants\u0026apos; delivery records. The data was analysed using SPSS 26.0 and Microsoft Office Excel 2019. Statistical tools such as Descriptive statistics (frequencies, cross-tabulations, and chi-square tests) were used to generate the results. The results are presented as frequencies (percentages), medians, and interquartile ranges.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSocio-Demographic and Clinical Symptoms of Study Participants Stratified by HIV Status\u003c/h2\u003e \u003cp\u003eThe socio-demographic characteristics of the study participants are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. No significant differences in age distribution, marital status, occupation, or geographical zone were observed between WWH and WWoH. However, educational status differed significantly, with more WWoH women having attained tertiary education. Partner HIV status also showed a significant difference, with 26% of partners of WWH also having HIV, compared to none among WWoH. For symptoms and complaints during pregnancy, vaginal discharge was more frequently reported by pregnant WWH, approaching statistical significance.\u003c/p\u003e \u003cp\u003eIn Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the median age of WWH was 36 years (IQR: 31\u0026ndash;40) and was statistically significantly higher than the median age of 33 years (IQR: 28\u0026ndash;37) in WWoH (p\u0026thinsp;=\u0026thinsp;0.031). Maternal weight was also significantly greater among WWH, with a median of 84 kg (IQR: 84\u0026ndash;88), compared to 74 kg (IQR: 62\u0026ndash;83) in WWoH (p\u0026thinsp;=\u0026thinsp;0.040). Height did not differ significantly between groups (p\u0026thinsp;=\u0026thinsp;0.071). Symphysis fundal height (SFH) was significantly higher in WWH, with a median of 22 cm (IQR: 20\u0026ndash;25), versus 20.44 cm (IQR: 18.33\u0026ndash;24.80) in WWoH (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Temperature and respiratory rate were also significantly elevated in both groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 for both). Pulse rate and systolic blood pressure showed no significant differences, while diastolic blood pressure was significantly lower in WWH (p\u0026thinsp;=\u0026thinsp;0.009). There were no significant differences in gestational age at visit or delivery between the groups. However, infant birth weight was significantly lower among WWH, with a median of 2.8 kg (IQR: 2.3\u0026ndash;3.2) compared with 3.2 kg (IQR: 2.7\u0026ndash;3.5) in the WWoH group (p\u0026thinsp;=\u0026thinsp;0.035).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic Characteristics and Clinical Symptoms of Study Participants Stratified by HIV Status\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVARI VARIABLES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c7\" namest=\"c3\"\u003e \u003cp\u003ePARTICIPANTS, N\u0026thinsp;=\u0026thinsp;100\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eWWH: N\u0026thinsp;=\u0026thinsp;50\u003c/p\u003e \u003cp\u003eFREQUENCY (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWWoH: N\u0026thinsp;=\u0026thinsp;50\u003c/p\u003e \u003cp\u003eFREQUENCY (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eSocio-demographic variables\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e2.988\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.224\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34 (Optimal Reproductive Age)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e23(42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (57.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;39 (Advanced Maternal Age 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e13(54.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (45.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40+ (Age Maternal Age 2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e14(63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(36.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e6.179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3(6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e16(32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e31(62%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare and Allied Professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e9.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.107\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffice-Based Professional (non-Health)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e6(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraders and Small Business Owners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e35(70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23(46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled and Unskilled Labour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7(14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.603\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGeographical Zone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorth Central\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7(14.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e2.646\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.619\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorth West\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth East\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e18(36.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth South\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e6(12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth West\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e19(38.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eROTAVIRUS STATUS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.895\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49 (98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46 (92%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95 (95%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePartner's HIV Serostatus\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive (HIV-1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e13 (26.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4.943\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e37 (74.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e87 (87%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSymptoms/ Complaints Experienced During Pregnancy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiarrhoea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChest Pains\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOdynophagia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbdominal Pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal Discharge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e44(88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3.840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.050\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e6(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoss of Appetite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.344\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersistent Vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48(96.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.153\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2(4.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShortness of Breadth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkin Rash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers (Body/waist pain)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e50(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(98%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical Data of Study Participants Stratified by HIV Status\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eVARIABLES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003ePARTICIPANTS, N\u0026thinsp;=\u0026thinsp;100\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWWH: N\u0026thinsp;=\u0026thinsp;50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWWoH: N\u0026thinsp;=\u0026thinsp;50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEDIAN (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMEDIAN (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (\u003cspan additionalcitationids=\"CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (\u003cspan additionalcitationids=\"CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMaternal Anthropometric and Vital Signs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (84\u0026ndash;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (62\u0026ndash;83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(149). (120\u0026ndash;160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e166 (160\u0026ndash;168)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSFH (Symphysis Fundal Height-cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (\u003cspan additionalcitationids=\"CR21 CR22 CR23 CR24\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.44 (18.33\u0026ndash;24.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemperature(\u0026ordm;C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.5 (36.4\u0026ndash;36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.0 (35.5\u0026ndash;36.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.922\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory rate (cycles/min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulse (beats/min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (85\u0026ndash;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95(85\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.383\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eBP (mm/Hg)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSystolic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiastolic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e8.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnancy and Delivery Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGestational Age at Visit (weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(\u003cspan additionalcitationids=\"CR22 CR23 CR24\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.400\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGestational Age at Delivery (weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38 (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.873\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.188\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfant weight (kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.8(2.3\u0026ndash;3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2 (2.7\u0026ndash;3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDistribution of Rotavirus Groups (A, B, C) among Study Participants by HIV Status\u003c/h3\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e summarises the distribution of rotavirus group-specific detections among pregnant women in the study population. Although the overall rotavirus-positive count was five based on the non-group-specific assay, group-level analysis identified six group-specific detections because one participant tested positive for both Rotavirus Group B and Group C. This dual positivity accounts for the numerical discrepancy between the total rotavirus-positive count and the sum of group-specific detections.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of Rotavirus Groups B and C With Identification of Dual Positivity Among Study Participants Stratified by HIV Status and Adjusted for Co-classification\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRotavirus Group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWWoH (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWWH (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal Detections\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNotes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo detection\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOne participant was co-positive with Group C\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup C\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIncludes the co-positive individual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUnique Rotavirus-Positive Individuals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026mdash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026mdash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal unique cases (non-group-specific assay)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eAssociation of Rotavirus Groups with Pregnancy Outcomes of all study participants\u003c/h3\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the association between Rotavirus groups (A, B, and C) and pregnancy outcomes among all study participants. No positive cases of Rotavirus Group A were detected; therefore, all participants were negative, with 79 experiencing expected pregnancy outcomes and 21 reporting adverse outcomes. For Rotavirus Group B, 2 participants tested positive, and both had normal pregnancy outcomes. Among participants who were negative for Group B, 77 had expected outcomes while 21 had adverse outcomes. This association was not statistically significant (χ\u0026sup2; = 0.542, p\u0026thinsp;=\u0026thinsp;0.461). Similarly, for Rotavirus Group C, 3 participants tested positive; one of these experienced an adverse pregnancy outcome, while the remaining had expected outcomes. Among Group C-negative participants, 76 had normal outcomes, and 20 had adverse outcomes, with no significant association observed (χ\u0026sup2; = 0.040, p\u0026thinsp;=\u0026thinsp;0.841). Analysis of the association between all rotavirus groups and pregnancy outcomes showed no significant association (χ\u0026sup2; = 0.003, p\u0026thinsp;=\u0026thinsp;0.955). Among women with rotavirus positivity, 4 had normal birth outcomes, whereas 1 experienced an adverse outcome. Similarly, 75 of the rotavirus-negative women had normal outcomes, and 20 had adverse outcomes, indicating no significant difference between the two groups. The relationship between rotavirus infection and specific birth outcomes was not statistically significant (χ\u0026sup2; = 2.008, p\u0026thinsp;=\u0026thinsp;0.848). Among rotavirus-positive women, 4 had normal birth outcomes, whereas one experienced low birth weight (LBW). In contrast, among rotavirus-negative women, 75 had normal outcomes, and 20 (19.8%) had various adverse outcomes, including LBW, preterm birth (PTB), and stillbirth. The distribution of specific adverse birth outcomes, including low birthweight (LBW), preterm birth (PTB), and stillbirth, across the different Rotavirus groups is illustrated in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003ec.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003ea\u003c/b\u003e: Association between Rotavirus Groups in Relation to Pregnancy Outcomes among Study Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eROTAVIRUS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePREGNANCY OUTCOMES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eROTAVIRUS GROUP A\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNORMAL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eADVERSE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSITIVE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNEGATIVE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eROTAVIRUS GROUP B\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSITIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.461\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNEGATIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eROTAVIRUS GROUP C\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSITIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.841\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNEGATIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb: Association between Rotavirus in Relation to Pregnancy Outcomes among Study Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eROTAVIRUS (All groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eBIRTH OUTCOMES\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNORMAL (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eADVERSE (%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSITIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNEGATIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75 (75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ec: Association between Rotavirus in Relation to Specific Pregnancy Outcomes among Study Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eROTAVIRUS (All groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eBIRTH OUTCOMES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNORMAL\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003eADVERSE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLBW\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLBW, PTB (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLBW, STILLBIRTH,\u003c/p\u003e \u003cp\u003ePTB (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePTB\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSTILL\u003c/p\u003e \u003cp\u003eBIRTH\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSITIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.848\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNEGATIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAssociation of Rotavirus Groups and Pregnancy Outcomes among Study Participants by HIV Status\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows pregnancy outcomes categorised as normal or adverse among women living with HIV and WWoH women, stratified by rotavirus group (A, B, and C) status and presence. Across all groups, the majority of women had normal pregnancy outcomes regardless of HIV status or rotavirus detection. For Rotavirus Group A, all rotavirus tests were negative in both WWH and WWoH; therefore, statistical analysis was not performed. In Groups B and C, rotavirus was detected in a small minority of WWoH (Group B: 2 positives; Group C: 3 positives) and in very few WWH (Group C: 1 positive). The chi-square (χ\u0026sup2;) values and associated p-values across these comparisons (Group B: χ\u0026sup2;=0.284, p\u0026thinsp;=\u0026thinsp;0.594; Group C: χ\u0026sup2;=0.437 and 1.375, p\u0026thinsp;=\u0026thinsp;0.508 and 0.241) indicate no statistically significant associations between rotavirus presence, HIV status, and adverse pregnancy outcomes in this sample. The distribution of Rotavirus and the different adverse birth outcomes, which include Low birthweight (LBW), Pre-term birth (PTB), and Stillbirth, by HIV Status is presented in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e5\u003c/span\u003eb with no significant difference as well.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea: Association Between RV Positives by HIV Status and Birth Outcome Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" morerows=\"1\" nameend=\"c3\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eBIRTH OUTCOME ROTAVIRUS STATUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eHIV STATUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eΧ\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWWH\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWWoH\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eADVERSE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNORMAL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb: Association Between RV Positives by HIV Status and Specific Adverse Birth Outcomes\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" morerows=\"1\" nameend=\"c3\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eBIRTH OUTCOME ROTAVIRUS STATUS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eHIV STATUS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eΧ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-VALUE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWWH\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWWoH\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLBW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e7.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLBW, PTB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLBW, STILL BIRTH, PTB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNORMAL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTILL BIRTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRotavirus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003enegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003epositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eRotavirus infection is globally recognised as a significant cause of acute gastroenteritis, with Group A being the most commonly reported strain in humans. Although primarily a paediatric disease, rotavirus can also infect adults, including pregnant women, potentially influencing pregnancy outcomes through dehydration, malnutrition, or immune-mediated mechanisms. The situation may be of particular concern in WWH, whose immune suppression could predispose them to more severe or prolonged infections. However, data on rotavirus infection during pregnancy in Nigeria, especially in relation to HIV status, are limited. Most published studies have focused on children under five years of age, leaving an important knowledge gap regarding maternal infection and pregnancy outcomes. To our knowledge, our study is the first to report the prevalence of rotavirus infection and its association with pregnancy outcomes among pregnant women in Nigeria, comparing WWH and WWoH.\u003c/p\u003e \u003cp\u003eAlthough studies specifically assessing active rotavirus infection in pregnancy are rare, evidence indicates that most pregnant women possess antibodies against rotavirus, which are transferred to their infants postpartum (Meier \u003cem\u003eet al\u003c/em\u003e., 2017). Rotavirus Groups A, B, and C are all known to cause gastroenteritis but differ in epidemiology, host susceptibility, and disease severity (Bresee, 2020). In adults, Group A rotavirus infection is usually asymptomatic or causes mild-to-moderate diarrhoea that is often self-limiting (Anderson \u0026amp; Weber, 2004). Group B, while less prevalent, has caused large outbreaks among adults in China and has been detected in other parts of the world (Zhong \u003cem\u003eet al\u003c/em\u003e, 1997). Group C rotavirus, though typically associated with milder disease, disproportionately affects older children and adults (Tian \u003cem\u003eet al\u003c/em\u003e., 2024). In our study, five participants tested positive for rotavirus infection. The discrepancy between the overall rotavirus prevalence (five cases) and the six detections observed in the group-specific analysis (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) is explained by one participant who tested positive for both Rotavirus Groups B and C. Thus, the group-level assays identified six strain-specific signals; the number of unique infected individuals remained five. Mixed infections of different rotavirus groups are biologically plausible and have been documented in settings with co-circulating strains (Nyaga \u003cem\u003eet al\u003c/em\u003e., 2015). Notably, only Groups B and C were detected; Group A was not identified, suggesting an unusual circulation pattern distinct from regions where Group A is typically dominant. These findings highlight the added value of group-specific typing in revealing infections that non-typing screening assays may underestimate. The absence of Group A detection in this study could be related to the national rotavirus vaccination programme introduced in 2022, which targets Group A strains explicitly and may have contributed to reduced transmission (Oladunni \u003cem\u003eet al\u003c/em\u003e., 2024). Unexpectedly, a higher prevalence of Groups B and C was observed among WWoH compared with WWH, contrary to expectations that immunocompromised individuals, such as WWH, are at increased risk of enteric infections. Similar findings have been reported in other African settings, where rotavirus infection rates were not consistently higher among PWH (Khumalo \u003cem\u003eet al\u003c/em\u003e., 2020). Several plausible explanations may account for this pattern. Firstly, the use of antiretroviral therapy (ART) in WWH may enhance immune reconstitution and gut mucosal defence, thereby reducing susceptibility to or severity of rotavirus infections for pregnant WWH. Secondly, although both WWH and WWoH receive antenatal care, WWH often undergo more frequent medical follow-up and receive targeted counselling on hygiene and infection prevention. This increased contact with healthcare providers may reduce their exposure to contaminated water and food sources. Despite the observed differences in prevalence, no statistically significant association was found between rotavirus infection and adverse pregnancy outcomes in this study. Outcomes, including low birthweight (LBW), preterm birth (PTB), combined LBW and PTB, and stillbirth, were observed among both rotavirus-positive and -negative participants. However, these outcomes occurred more frequently in women who tested negative for rotavirus than in those who tested positive, suggesting that rotavirus infection was not a significant determinant of pregnancy complications in this cohort. This finding aligns with the observations of Inal \u003cem\u003eet al\u003c/em\u003e. (2018), who reported no significant association between maternal enteric viral infections, including rotavirus, and adverse pregnancy outcomes in a prospective cohort study.\u003c/p\u003e \u003cp\u003eOnly one adverse outcome was recorded among Rotavirus Group C positive participants, while none occurred in Group B positive cases. The predominance of expected pregnancy outcomes among women infected with rotavirus suggests that rotavirus infection exerts minimal or no direct effect on foetal development or delivery outcomes. This is consistent with existing evidence showing that rotavirus infection in adults is typically confined to the gastrointestinal tract, with limited potential for systemic dissemination or vertical transmission (Parashar \u003cem\u003eet al\u003c/em\u003e., 2003; Crawford \u003cem\u003eet al\u003c/em\u003e., 2017; Rolfe \u0026amp; Daryaei, 2020). Moreover, most enteric viral infections are self-limiting and rarely lead to adverse obstetric outcomes unless complicated by severe dehydration, fever, or concurrent infections (Crawford \u003cem\u003eet al\u003c/em\u003e., 2017; Stuempfig \u003cem\u003eet al\u003c/em\u003e., 2025); nevertheless, indirect mechanisms cannot be entirely excluded. However, if most infections in this study were mild or subclinical and pre-existing maternal antibodies were present, these factors may have reduced the likelihood of adverse effects, although this could not be directly confirmed in this study (Beltrami \u003cem\u003eet al\u003c/em\u003e., 2023).\u003c/p\u003e \u003cp\u003eThe significantly higher median age observed among pregnant WWH (36 years) compared with their HIV-seronegative counterparts (33 years) is physiologically relevant because advancing maternal age is independently associated with increased obstetric risks, including low birthweight, preterm birth, and stillbirth (Abebe \u003cem\u003eet al\u003c/em\u003e., 2025). These risks are partly driven by age-related vascular, metabolic, and immunological changes that can affect foetal growth and overall pregnancy stability (Neiger, 2017). Interestingly, despite being older on average, WWH in this study did not experience adverse outcomes in the rotavirus-positive subgroup, whereas all adverse outcomes occurred among younger, WWoH. This pattern suggests that maternal age alone does not account for the distribution of pregnancy outcomes in this cohort. Instead, it highlights the possibility that other factors, such as differential health-seeking behaviour, routine HIV-related clinical monitoring, ART-driven immune stabilisation, or unmeasured sociodemographic variables, may have played a more influential role. These findings underscore the need for larger studies to disentangle the biological and contextual drivers of pregnancy outcomes in mixed HIV-status populations.\u003c/p\u003e \u003cp\u003eAnother noteworthy observation in this study is the significantly lower infant birthweight among WWH on ART compared with WWoH. This finding aligns with established evidence that HIV infection, even in the era of effective ART, can influence foetal growth through other factors that can lead to pregnancy complications (Fleșeriu \u003cem\u003eet al\u003c/em\u003e., 2024). The lower birth weight observed among WWH, despite the absence of rotavirus-associated adverse outcomes in this group, suggests that underlying HIV-related physiological factors may exert a more consistent impact on fetal growth than acute viral infections such as rotavirus (Muhangi \u003cem\u003eet al\u003c/em\u003e., 2013). When considered alongside the older median age of WWH, this lower birth-weight pattern indicates a multifactorial interplay where maternal age, HIV-associated immune dysregulation, and ART exposure may collectively shape foetal growth trajectories. Importantly, these HIV-related effects appear independent of rotavirus infection, reinforcing the conclusion that rotavirus showed no evidence of a significant role in determining pregnancy outcomes in this cohort.\u003c/p\u003e \u003cp\u003eOverall, this study demonstrates that maternal rotavirus infection was uncommon and not associated with adverse pregnancy outcomes. Instead, HIV-related factors, notably lower infant birthweight, remain more clinically relevant. Further research with larger sample sizes is needed to validate these findings and explore the mechanisms by which HIV and its treatment influence foetal growth and maternal susceptibility to Rotavirus infections (Khumalo \u003cem\u003eet al\u003c/em\u003e., 2020).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, rotavirus infection was uncommon in this cohort of pregnant women. Although a higher proportion of cases occurred among WWoH compared with WWH, this difference was slight, statistically non-significant, and likely incidental. The predominance of Rotavirus Groups B and C, alongside the absence of Group A, suggests possible shifts in circulating strains following the introduction of the Group A targeted vaccine into Nigeria\u0026rsquo;s national immunisation program. Notably, there was no evidence of increased risk of adverse pregnancy outcomes in WWH due to rotavirus infection, as nearly all complications occurred among WWoH. These findings suggest that, within this population, rotavirus contributes minimally to obstetric risk, whereas HIV-related physiological factors, such as lower infant birthweight, remain more clinically relevant. Larger studies are needed to confirm these observations and to clarify the broader epidemiological relevance of rotavirus infection during pregnancy in Nigeria.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eClinical and Epidemiological Implications\u003c/h2\u003e \u003cp\u003eRotavirus infection was not significantly associated with adverse pregnancy outcomes in this cohort. Most infected women experienced regular deliveries, suggesting that rotavirus infections during pregnancy are typically mild and self-limiting. The detection of non-Group A strains (Groups B and C) also highlights a noteworthy observation, underscoring the importance of sustained rotavirus surveillance.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePublic Health Implications\u003c/h2\u003e \u003cp\u003eThis finding of higher rotavirus prevalence among WWoH underscores the complex interplay between host immunity, ART-related immune restoration, and environmental exposure risks. These findings emphasise the need for strengthened antenatal care systems, improved hygiene education, and guaranteed access to safe water and food as key preventive measures to reduce enteric infections in pregnancy among WWoH.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eA key strength of this study is its focus on rotavirus infection among pregnant women, a population often overlooked in enteric virus research in sub-Saharan Africa. The inclusion of both WWH and WWoH allowed for comparative insights into immune and epidemiological dynamics. Additionally, molecular detection of Rotavirus Groups A, B, and C provides early evidence of shifting strain patterns in the post-vaccine era. However, limitations include a modest sample size, which may reduce statistical power, and a cross-sectional design, which precludes causal inferences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eFuture Directions\u003c/h2\u003e \u003cp\u003eFuture research employing larger, multicentre cohorts and longitudinal follow-up to assess temporal patterns and causal links between maternal rotavirus infection and pregnancy outcomes is indicated. Incorporating viral quantification and immune profiling will help clarify the roles of gut immunity and environmental factors in rotavirus susceptibility across WWH and HIV-seronegative groups. Such studies are essential to guide vaccine strategy, strengthen maternal infection surveillance, and improve health outcomes for women and infants in endemic, resource-limited regions.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate:\u0026nbsp;\u003c/strong\u003eThis study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki, and ethical clearance (IRB/22/053) was obtained from the Institutional Review Board of the Nigerian Institute of Medical Research, Yaba, Lagos. Written informed consent was obtained from all participants prior to participation in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Not applicable. The study did not include any individual person\u0026rsquo;s data in an identifiable form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials:\u003c/strong\u003e The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions:\u0026nbsp;\u003c/strong\u003eOSA designed the study and supervised the research. OJO conducted the study, performed sample collection, laboratory analysis, and drafted the manuscript; TIO performed laboratory analysis and drafted the manuscript, FA performed laboratory analysis and manuscript writing, EUU performed laboratory analysis, and OJ performed laboratory analysis. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e The authors acknowledge the clinic staff of the Nigerian Institute of Medical Research, the Federal Medical Centre, and the Lagos University Teaching Hospital, which facilitated access to the samples used in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbebe YM, Deribe L, Fantahun A, Beyene BN, Megule SM, Shiferaw WG, Adugna KF, Tessema LW, Getu AA, Kassahun EA, Alemayehu BA, Nega AT, Azene Z, Bante SA, Awoke AM, Chekole FA, Balcha WF. 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Unique Scientific Publishers. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.47278/book.oht/2023.16\u003c/span\u003e\u003cspan address=\"10.47278/book.oht/2023.16\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhong M, Yan P, Xie M. Human rotavirus infection in perinatal transmission [Article in Chinese]. Zhonghua fu chan ke za zhi. 1997;32(12):735\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/9772438\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/9772438\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Rotavirus infection, Pregnancy outcomes, Maternal HIV infection, Sub-Saharan Africa, Nigeria","lastPublishedDoi":"10.21203/rs.3.rs-8524249/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8524249/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Although rotavirus infection in pregnancy is generally considered self-limiting, maternal dehydration and systemic inflammatory responses may adversely affect pregnancy outcomes. However, the potential modifying effect of maternal HIV status remains poorly understood. This study examined the prevalence of rotavirus infection and its relationship to adverse pregnancy outcomes among women living with and without HIV.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e:\u003cstrong\u003e \u003c/strong\u003eWe conducted a cross-sectional study of 100 pregnant women (50 women with HIV (WWH) and 50 women without HIV(WWoH) attending a public tertiary hospital in Lagos, Nigeria. Stool samples were tested for rotavirus by PCR. HIV status was confirmed using the Nigerian HIV testing algorithm and used to categorize associations with pregnancy outcomes, including low birthweight (LBW), preterm birth, and stillbirth.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Overall rotavirus prevalence was 5%, with a higher prevalence in WWoH (8%) compared to WWH (2%). Of the five rotavirus-positive participants, two had Group B rotavirus, 3 had Group C rotavirus, and one was positive for both Group B and Group C. Similarly, the distribution of pregnancy outcomes among the rotavirus-positive participants shows that four had normal pregnancy outcomes, and one had adverse pregnancy outcomes.\u003c/p\u003e\n\u003cp\u003eIn contrast, adverse outcomes, including low birthweight (n=6) and combined low birthweight with preterm birth (n=8), occurred exclusively among rotavirus-negative women. Further analysis shows that no stillbirths were associated with rotavirus infection. Additionally, among rotavirus-positive participants, four WWH had normal pregnancy outcomes, whereas one WWoH had an adverse outcome, specifically low birth weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eRotavirus infection was more frequently detected among WWH than among WWoH. The absence of a consistent association between maternal rotavirus infection and low birth weight, preterm birth, or stillbirth suggests that rotavirus infection during pregnancy did not meaningfully contribute to adverse outcomes in this cohort. Therefore, further studies with larger sample sizes are needed to validate these findings.\u003c/p\u003e","manuscriptTitle":"Rotavirus-Associated Adverse Pregnancy Outcomes among Women Without HIV Compared to Women Living with HIV","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-09 12:55:58","doi":"10.21203/rs.3.rs-8524249/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-17T06:06:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263333023614114259752389948286502649451","date":"2026-02-16T04:46:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-05T12:04:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-09T11:05:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-07T10:37:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-07T10:32:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-01-05T18:34:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0c873d5d-6c96-41f3-945a-e6fd21ba19fc","owner":[],"postedDate":"February 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T12:55:58+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-09 12:55:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8524249","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8524249","identity":"rs-8524249","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}