[Premature labor in HIV infected women. Swiss "HIV and Pregnancy" Study Group].
In the Swiss Study "HIV and pregnancy" we observed 153 singleton pregnancies of HIV-positive women. 23 (15%) of those ended with a premature delivery. For drug addicts (n = 100), the incidence of prematurity, 20%, significantly higher than in those free of drugs (n = 53) with 5.6%. The most frequent cause of prematurity was premature labor or rupture of the membranes (n = 13), followed by maternal illness (n = 8) and fetal complications (n = 2). Women with premature delivery tended to have lower CD4 cell counts than those with term delivery (29.4% vs 12.0% with < 200 CD4 cells/microliters). Low CD4 cell counts and drug consumption are two independent but cumulative risks for severe infections. 16 of the 153 women (12 with, 4 without drug consumption) had severe infections during pregnancy; in 4 cases (25%), this led to prematurity. The most common infection was pneumonia (14/16), further one case of pyelonephritis and one of cerebral toxoplasmosis. Two of these 16 infants (12.5%) were HIV-positive. We could not confirm a relationship between prematurity and vertical HIV transmission. Of the HIV-classified children, 3/18 (16.7%) premature infants and 16/74 (21.6%) term infants were infected.
Zürrer
M
M
Klinik und Poliklinik für Geburtshilfe, Universitätsspital Zürich.
Biedermann
K
K
Rudin
C
C
Lauper
U
U
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005113:Extraction, Obstetrical; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000276:immunology; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000276:immunology; D018566:Pregnancy, High-Risk; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000276:immunology; D013557:Switzerland / Q000453:epidemiology
Frühgeburtlichkeit bei HIV-infizierten Frauen. Schweizerische Arbeitsgruppe "HIV und Schwangerschaft".