Title

Risk factors for mother-to-child transmission of human immunodeficiency virus-1 infection

Document Type

Article

Department

Obstetrics and Gynaecology (East Africa)

Abstract

OBJECTIVE: Our aim was to examine maternal, obstetric, and infant characteristics of mother-to-child transmission of human immunodeficiency virus-1 in Nairobi, Kenya.

STUDY DESIGN: Proviral human immunodeficiency virus-1 was detected by polymerase chain reaction in peripheral blood samp0les taken between 6 weeks and 3 months of age from 107 children born to human immunodeficiency virus-1 seropositive women. The association of maternal, infant, and obstetric variables with human immunodeficiency virus-1 transmission was examined.

RESULTS: The mother-to-child transmission rate was 31% (95% confidence interval 21.6 to 40.2) as defined by the presence of proviral human immunodeficiency virus-1 in the infant. Variables associated with transmission in a univariate analysis included placental inflammation(712 in the transmitting group as compared with222 in nontransmitters, p = 0.006), low maternal CD4 and high CD8 percentages (21% and 52%, respectively, in transmitting mothers and 32% and 40% in nontransmitting mothers; p = 0.001), and the gender of the neonates (2029 infected neonates were female as compared with 2665" role="presentation"> noninfected children, p = 0.02). Sexually transmitted diseases were found more often in transmitting mothers but the differences were not significant. Birth weight and gestational age were not related to vertical transmission of human immunodeficiency virus-1.

CONCLUSION: Risk factors for mother-to-child transmission of human immunodeficiency virus-1 included chorioamnionitis, an impaired maternal immune status, and female gender.

Comments

This work was published before the author joined Aga Khan University.

Publication

American Journal of Obstetrics and Gynecology

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