Perioperative morbidity and mortality among human immunodeficiency virus infected women undergoing cesarean delivery.
OBJECTIVE
To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection.


METHODS
A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications.


RESULTS
There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2).


CONCLUSIONS
Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality.


METHODS
II.
Wayne State University, Detroit, MI, USA. judette.louis@hotmail.com
Judette
J
Louis
Mark B
MB
Landon
Rebecca J
RJ
Gersnoviez
Kenneth J
KJ
Leveno
Catherine Y
CY
Spong
Dwight J
DJ
Rouse
Atef H
AH
Moawad
Michael W
MW
Varner
Steve N
SN
Caritis
Margaret
M
Harper
Ronald J
RJ
Wapner
Menachem
M
Miodovnik
Marshall
M
Carpenter
Alan M
AM
Peaceman
Mary J
MJ
O'Sullivan
Baha M
BM
Sibai
Oded
O
Langer
John M
JM
Thorp
Susan M
SM
Ramin
Brian M
BM
Mercer
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008428:Maternal Mortality; D009017:Morbidity; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology