title: Prevalence of congenital cardiovascular malformations in children of human immunodeficiency virus-infected women: the prospective P2C2 HIV Multicenter Study. P2C2 HIV Study Group, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
abstract: OBJECTIVE
  The purpose of the study was to assess the effects of maternal HIV-1 (human immunodeficiency virus) infection and vertically transmitted HIV-1 infection on the prevalence of congenital cardiovascular malformations in children.
  
  
  BACKGROUND
  In the United States, an estimated 7000 children are born to HIV-infected women annually. Previous limited reports have suggested an increase in the prevalence of congenital cardiovascular malformations in vertically transmitted HIV-infected children.
  
  
  METHODS
  In a prospective longitudinal multicenter study, diagnostic echocardiograms were performed at 4-6-month intervals on two cohorts of children exposed to maternal HIV-1 infection: 1) a Neonatal Cohort of 90 HIV-infected, 449 HIV-uninfected and 19 HIV-indeterminate children; and 2) an Older HIV-Infected Cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age.
  
  
  RESULTS
  In the Neonatal Cohort, 36 lesions were seen in 36 patients, yielding an overall congenital cardiovascular malformation prevalence of 6.5% (36/558), with a 8.9% (8/90) prevalence in HIV-infected children and a 5.6% (25/449) prevalence in HIV-uninfected children. Two children (2/558, 0.4%) had cyanotic lesions. In the Older HIV-Infected Cohort, there was a congenital cardiovascular malformation prevalence of 7.5% (15/201). The distribution of lesions did not differ significantly between the groups.
  
  
  CONCLUSIONS
  There was no statistically significant difference in congenital cardiovascular malformation prevalence in HIV-infected versus HIV-uninfected children born to HIV-infected women. With the use of early screening echocardiography, rates of congenital cardiovascular malformations in both the HIV-infected and HIV-uninfected children were five- to ten-fold higher than rates reported in population-based epidemiologic studies but not higher than in normal populations similarly screened. Potentially important subclinical congenital cardiovascular malformations were detected.
authors.affiliation: Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA. Wyman_Lai@smtplink.mssm.edu
authors.forename: W W
authors.initials: WW
authors.lastname: Lai
authors.forename: S E
authors.initials: SE
authors.lastname: Lipshultz
authors.forename: K A
authors.initials: KA
authors.lastname: Easley
authors.forename: T J
authors.initials: TJ
authors.lastname: Starc
authors.forename: S E
authors.initials: SE
authors.lastname: Drant
authors.forename: J T
authors.initials: JT
authors.lastname: Bricker
authors.forename: S D
authors.initials: SD
authors.lastname: Colan
authors.forename: D S
authors.initials: DS
authors.lastname: Moodie
authors.forename: G
authors.initials: G
authors.lastname: Sopko
authors.forename: S
authors.initials: S
authors.lastname: Kaplan
mesh_terms: D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000635:transmission; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000209:etiology*; D006344:Heart Septal Defects, Atrial / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D015995:Prevalence; D011446:Prospective Studies