Mode of delivery and neonatal respiratory morbidity among HIV-exposed newborns in Latin America and the Caribbean: NISDI Perinatal-LILAC Studies
- PMID: 21620404
- PMCID: PMC3368433
- DOI: 10.1016/j.ijgo.2011.02.008
Mode of delivery and neonatal respiratory morbidity among HIV-exposed newborns in Latin America and the Caribbean: NISDI Perinatal-LILAC Studies
Abstract
Objective: To evaluate respiratory morbidity (RM) in HIV-exposed newborns according to mode of delivery.
Methods: The NISDI Perinatal/LILAC prospective cohort studies enrolled HIV-infected pregnant women and their newborns in Latin America and the Caribbean. Associations between RM and delivery mode or other characteristics were evaluated.
Results: Between September 2002 and December 2009, 1630 women were enrolled, and 1443 mother-infant pairs met the inclusion criteria. There were 561 vaginal (VD), 269 cesarean before labor and membrane rupture (SCS) for preventing mother-to-child transmission (SCS-PMTCT), 248 other SCS, and 365 cesarean after labor and/or ruptured membranes (NSCS) deliveries. In total, 108 (7.5%) newborns had RM: 49 had respiratory distress syndrome (RDS), 39 had transient tachypnea (TTN), and 28 had other events (7 newborns had >1 RM event). Delivery mode was associated with RDS (P<0.005) and TTN (P<0.001). The proportion with RDS and TTN was lowest for VD (1.6% and 0.5%, respectively), highest for NSCS (4.9% and 4.7%), and intermediate for SCS-PMTCT (3.0% and 2.6%). Newborns with RDS or TTN were hospitalized longer (median +1day) than those without. A minority required ventilatory support (RDS, 24.5%-28.6%; TTN, 2.6%-15.4%).
Conclusions: SCS-PMTCT is relatively safe for newborns of HIV-infected women.
Copyright © 2011 International Federation of Gynecology and Obstetrics. All rights reserved.
Conflict of interest statement
The authors have no conflicts of interest.
References
-
- European Mode of Delivery Collaboration. Elective caesarean-section versus vaginal delivery in prevention of vertical HIV-1 transmission: a randomised clinical trial. Lancet. 1999;353(9158):1035–1039. - PubMed
-
- The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1—a meta-analysis of 15 prospective cohort studies. The International Perinatal HIV Group. N Engl J Med. 1999;340(13):977–987. - PubMed
-
- Panel on Treatment of HIV Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1 infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. www.nih.gov. http://aidsinfo.nih.gov/contentfiles/PerinatalGL.pdf. Published 2010. Accessed 2011. - PubMed
-
- Committee on Obstetric Practice. ACOG committee opinion scheduled Cesarean delivery and the prevention of vertical transmission of HIV infection. Number 234, May 2000 (replaces number 219, August 1999) Int J Gynecol Obstet. 2001;73(3):279–281. - PubMed
-
- American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 394, December 2007. Cesarean delivery on maternal request. Obstet Gynecol. 2007;110(6):1501. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous