MATERNAL-INFANT HIV TRANSMISSION AND CIRCUMSTANCES OF DELIVERY

Objectives Circumstances of delivery among children with acquired immunodeficiency syndrome (AIDS) were investigated to assess whether they were consistent with predictions that:intrapartum factors affect the risk of maternal-infant human immunodeficiency virus (HIV) transmission. Methods Pediatric AIDS patients (maternal-infant transmission; n = 632) reported to the New York City Health Department through 1991 were compared with a series of infants born to predominantly uninfected women. For each case patient, five control subjects were selected and matched from birth certificate files. Hypothesized case-control comparisons for mode of delivery and preselected complications were tested. Results.:Compared with control subjects, case patients were less likely to have been delivered by cesarean section without complications (odds ratio: [OR] = 0.77; 95% confidence interval [CI] = 0.59, 1.01) and more likely to have been delivered with complications, whether delivery was by cesarean section (OR = 1.54; 95% CI = 0.98, 2.43) or vaginal (OR = 1.66; 95% CI = 1.15, 2.39). Conclusions. Assuming that HIV-infected and uninfected women have comparable circumstances of delivery, conditional on sociomedical characteristics, these results suggest that intrapartum events may be associated:with maternal-infant HIV transmission.