Intrapartum fetal invasive procedures and perinatal transmission of HIV

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 87; no. 1; pp. 63 - 67
• Main Authors: Maiques, Vicente, Garcı́a-Tejedor, Amparo, Perales, Alfredo, Navarro, Clara
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.11.1999; Elsevier
• Subjects: AIDS/HIV; Biological and medical sciences; CD4 Lymphocyte Count; Cohort Studies; Delivery. Postpartum. Lactation; Electrodes; Female; Fetal Monitoring - adverse effects; Gynecology. Andrology. Obstetrics; HIV Infections - transmission; Human viral diseases; Humans; Hydrogen-Ion Concentration; Infectious Disease Transmission, Vertical; Infectious diseases; Medical sciences; Obstetrical techniques; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Risk Factors; Scalp - embryology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Maternal diseases; Electrodes; Mother; Cohort study; pH; Female; Fetus; Human; Immunopathology; Retroviridae; Perinatal; AIDS; Immune deficiency; Lentivirus; Retrospective; Infection; Virus; Newborn; Surveillance; Scalp; Viral disease; Risk factor; Vertical transmission; Technique; Human immunodeficiency virus
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(99)00081-0

Objective: To study the effect of intrapartum use of fetal invasive procedures (scalp electrodes or scalp pH sampling) on perinatal transmission rate of HIV. Study design: We compared the perinatal transmission of 57 HIV pregnancies in which invasive procedures (IP) were performed with a control group of 214 pregnancies without IP. We controlled for potentially risk factors (maternal CD4 level, gestational age, antiretroviral therapy use, duration of rupture of membranes (ROM), length of labor and mode of delivery) by stratification and logistic regression. Results: Transmission rate in the group with IP was 26.3% (15/57) versus 13.6% (29/214) in the control group, relative risk (RR) 1.9, 95% CI (1.1–3.4). By logistic regression we observed three significant factors involved in transmission of HIV: low maternal CD4 level (odds ratio (OR)=3.3, 95% CI=1.2–9.4), duration of ROM (OR=2.9, 95% CI=1.1–7.9) and IP use (OR=3.5, CI 95%=1.2–9.6). Interaction between duration of ROM and IP are also significant (OR=5.1, CI 95%=1.5–17.5). Conclusions: Intrapartum use of fetal scalp electrodes or fetal scalp pH sampling increases the perinatal transmission of HIV and should therefore be avoided in HIV patients.