Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child

Sheldon H. Landesman, Leslie A. Kalish, David N. Burns, Howard Minkoff, Harold E. Fox, Carmen Zorrilla, Pat Garcia, Mary Glenn Fowler, Lynne Mofenson, Ruth Tuomala

Research output: Contribution to journalArticle

Abstract

Background. A substantial proportion of perinatally acquired infections with the human immunodeficiency virus type 1 (HIV-1) occur at or near delivery, which suggests that obstetrical factors may have an important influence on transmission. We evaluated the relation of such factors and other variables to the perinatal transmission of HIV-1. Methods. The Women and Infants Transmission Study is a prospective, observational study of HIV-1-infected women who were enrolled during pregnancy and followed with their infants for three years after delivery. We studied obstetrical, clinical, immunologic, and virologic data on 525 women who delivered live singleton infants whose HIV-1-infection status was known as of August 31, 1994. Results. Among mothers with membranes that ruptured more than four hours before delivery, the rate of transmission of HIV-1 to the infants was 25 percent, as compared with 14 percent among mothers with membranes that ruptured four hours or less before delivery. In a multivariate analysis, the presence of ruptured membranes for more than four hours nearly doubled the risk of transmission (odds ratio, 1.82; 95 percent confidence interval, 1.10 to 3.00; P=0.02), regardless of the mode of delivery. The other maternal factors independently associated with transmission were illicit-drug use during pregnancy (odds ratio, 1.90; 95 percent confidence interval, 1.14 to 3.16; P= 0.01), low antenatal CD4+ lymphocyte count (

Original languageEnglish (US)
Pages (from-to)1617-1623
Number of pages7
JournalNew England Journal of Medicine
Volume334
Issue number25
StatePublished - Jun 20 1996

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HIV-1
Mothers
HIV
Membranes
Odds Ratio
Confidence Intervals
Pregnancy
Street Drugs
Virus Diseases
CD4 Lymphocyte Count
Observational Studies
Multivariate Analysis
Prospective Studies
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Landesman, S. H., Kalish, L. A., Burns, D. N., Minkoff, H., Fox, H. E., Zorrilla, C., ... Tuomala, R. (1996). Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child. New England Journal of Medicine, 334(25), 1617-1623.

Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child. / Landesman, Sheldon H.; Kalish, Leslie A.; Burns, David N.; Minkoff, Howard; Fox, Harold E.; Zorrilla, Carmen; Garcia, Pat; Fowler, Mary Glenn; Mofenson, Lynne; Tuomala, Ruth.

In: New England Journal of Medicine, Vol. 334, No. 25, 20.06.1996, p. 1617-1623.

Research output: Contribution to journalArticle

Landesman, SH, Kalish, LA, Burns, DN, Minkoff, H, Fox, HE, Zorrilla, C, Garcia, P, Fowler, MG, Mofenson, L & Tuomala, R 1996, 'Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child', New England Journal of Medicine, vol. 334, no. 25, pp. 1617-1623.
Landesman SH, Kalish LA, Burns DN, Minkoff H, Fox HE, Zorrilla C et al. Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child. New England Journal of Medicine. 1996 Jun 20;334(25):1617-1623.
Landesman, Sheldon H. ; Kalish, Leslie A. ; Burns, David N. ; Minkoff, Howard ; Fox, Harold E. ; Zorrilla, Carmen ; Garcia, Pat ; Fowler, Mary Glenn ; Mofenson, Lynne ; Tuomala, Ruth. / Obstetrical factors and the transmission of human immunodeficiency virus type I from mother to child. In: New England Journal of Medicine. 1996 ; Vol. 334, No. 25. pp. 1617-1623.
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