TY - JOUR
T1 - Duration of membrane rupture and risk of perinatal transmission of HIV-1 in the era of combination antiretroviral therapy
AU - Cotter, Amanda M.
AU - Brookfield, Kathleen F.
AU - Duthely, Lunthita M.
AU - Gonzalez Quintero, Victor H.
AU - Potter, Jonell E.
AU - O'Sullivan, Mary J.
N1 - Copyright © 2012 Mosby, Inc. All rights reserved.
PY - 2012/12
Y1 - 2012/12
N2 - Objective: The objective of the study was to determine whether the duration of membrane rupture of 4 or more hours is a significant risk factor for perinatal transmission of human immunodeficiency virus (HIV) in the era of combination antiretroviral therapy (ART). Study Design: This was a prospective cohort study of 717 HIV-infected pregnant women-infant pairs with a delivery viral load available who received prenatal care and delivered at our institution during the interval 1996-2008. Results: The cohort comprised 707 women receiving ART who delivered during this interval. The perinatal transmission rate was 1% in women with membranes ruptured for less than 4 hours and 1.9% when ruptured for 4 or more hours. For 493 women with a delivery viral load less than 1000 copies/mL receiving combination ART in pregnancy, there were no cases of perinatal transmission identified up to 25 hours of membrane rupture. Logistic regression demonstrated only a viral load above 10,000 copies/mL as an independent risk factor for perinatal transmission. Conclusion: Duration of membrane rupture of 4 or more hours is not a risk factor for perinatal transmission of HIV in women with a viral load less than 1000 copies/mL receiving combination ART.
AB - Objective: The objective of the study was to determine whether the duration of membrane rupture of 4 or more hours is a significant risk factor for perinatal transmission of human immunodeficiency virus (HIV) in the era of combination antiretroviral therapy (ART). Study Design: This was a prospective cohort study of 717 HIV-infected pregnant women-infant pairs with a delivery viral load available who received prenatal care and delivered at our institution during the interval 1996-2008. Results: The cohort comprised 707 women receiving ART who delivered during this interval. The perinatal transmission rate was 1% in women with membranes ruptured for less than 4 hours and 1.9% when ruptured for 4 or more hours. For 493 women with a delivery viral load less than 1000 copies/mL receiving combination ART in pregnancy, there were no cases of perinatal transmission identified up to 25 hours of membrane rupture. Logistic regression demonstrated only a viral load above 10,000 copies/mL as an independent risk factor for perinatal transmission. Conclusion: Duration of membrane rupture of 4 or more hours is not a risk factor for perinatal transmission of HIV in women with a viral load less than 1000 copies/mL receiving combination ART.
KW - antiretroviral therapy
KW - duration of membrane rupture
KW - perinatal transmission
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=84869474417&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2012.10.862
DO - 10.1016/j.ajog.2012.10.862
M3 - Article
C2 - 23103331
AN - SCOPUS:84869474417
SN - 0002-9378
VL - 207
SP - 482.e1-482.e5
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 6
ER -
