Newborn factors in maternal-infant transmission of pediatric HIV infection.
Factors affecting maternal-infant transmission (MIT) can be conveniently divided into 5 categories: (1) maternal factors (e.g. maternal immunologic status, anti-retroviral treatment), (2) virologic factors (e.g. viral load, strain, tissue tropism and resistance), (3) obstetric factors (e.g. traumatic delivery, chorioamnionitis, C-section), (4) fetal factors (e.g. prematurity, coinfection, twinning) and (5) infant factors (e.g. immune status, drugs, nutrition). Several of these factors (e.g., prematurity, maternal medication) can be classified as both maternal and fetal, and some factors (e.g. nutrition) include both fetal and neonatal period. This review focuses on the following six fetal/ infant factors: (1) timing of transmission, (2) prematurity, (3) fetal and neonatal nutrition, (4) neonatal GI function, (5) breastfeeding, and (6) the maturity of infant's immune system. Ways in which these factors may influence both the rate of MIT and the progression of the disease in the infant are discussed.
Stiehm
E R
ER
UCLA Department of Pediatrics, Los Angeles, CA 90095, USA.
D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D005315:Fetal Diseases; D005317:Fetal Growth Retardation / Q000209:etiology; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious