Complications according to mode of delivery among human immunodeficiency virus-infected women with CD4 lymphocyte counts of ≤500/μL

D. Heather Watts, John S. Lambert, E. Richard Stiehm, James Bethel, Jean Whitehouse, Mary Glenn Fowler, Jennifer Read

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: We sought to describe rates of and risk factors for complications by delivery mode among human immunodeficiency virus-infected women with CD4 counts of ≤500/μL. STUDY DESIGN: Complication rates were calculated by delivery mode, as follows: planned cesarean delivery performed without labor or rupture of membranes, other cesarean delivery performed after labor or rupture of membranes, or vaginal delivery. Risk factors were evaluated. RESULTS: Major complications in the planned cesarean delivery (n = 37), other cesarean delivery (n = 95), and vaginal delivery (n = 365) groups were amnionitis or endometritis (16%, 27%, and 7%, respectively), wound infection (5%, 8%, and <1%, respectively), and transfusion (8%, 6%, and 3%, respectively). Any peripartum infection occurred among 16 (18%) of those with a CD4 count of <200/μL and 43 (13%) with a CD4 count of ≥200/μL (P = .17). On multivariate analyses, factors associated with amnionitis-endometritis were cesarean delivery and African American race, and a factor associated with transfusion was third-trimester anemia. CONCLUSION: Endometritis and wound infection occurred more frequently among human immunodeficiency virus-infected women after cesarean than among women undergoing vaginal delivery; however, complication rates overall were within the range reported in human immunodeficiency virus-negative women. Measures to decrease complications in human immunodeficiency virus-infected women, such as greater use of prophylactic antibiotics, should be assessed.

Original languageEnglish (US)
Pages (from-to)100-107
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Volume183
Issue number1
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

Keywords

  • Human immunodeficiency virus-infected women
  • Postpartum complications

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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