Risk of perinatal transmission with treatment combinations of intrapartum and newborn zidovudine monotherapy.
OBJECTIVE
To determine perinatal transmission rates when zidovudine (ZDV) was given either to mothers after labor had begun, to their infants postnatally, or both.


METHODS
Woman-infant pairs who received intrapartum and newborn ZDV therapy between January 1, 1992, and July 1, 1998, were considered. A medical record review identified female subjects known to be HIV-infected. All women who were given treatment with any antiretroviral drug before the onset of labor were excluded. All women satisfying eligibility criteria were enrolled. Nonparametric tests were used for analysis. The transmission rate of the study population was compared with rates reported for mother-infant pairs in the United States who did not receive ZDV.


RESULTS
Administration of ZDV therapy after onset of labor resulted in a transmission rate of 11.9% (n = 59; 95% confidence interval [CI], 4.9 to 22.9). The overall perinatal transmission rate among women who received ZDV therapy after the onset of labor among sites in New York City was 6.3% (n = 32; CI, 0.8 to 20.8) compared with 18.5% (n = 27; CI, 6.3 to 38.0) among other sites. Administration of intrapartum therapy alone (n = 9), intrapartum plus newborn therapy (n = 37), and newborn therapy alone (n = 13) resulted in transmission rates of 11.1% (CI, 0.3 to 48.2), 13.5% (CI, 4.5 to 28.8), and 7.7% (CI, 0.2 to 36.0), respectively.


CONCLUSIONS
The transmission rates reported here are lower than rates reported when antiretroviral therapy was not administered.
Patchen
L
L
Center for Adolescent Women, TAPP Program, Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA.
Khoshnood
K
K
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003237:Connecticut / Q000453:epidemiology; D004334:Drug Administration Schedule; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008499:Medical Records; D009519:New York City / Q000453:epidemiology; D018743:Perinatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D015215:Zidovudine / Q000008:administration & dosage*
D019380:Anti-HIV Agents; D015215:Zidovudine