Perioperative cesarean delivery morbidity among HIV-infected women under highly active antiretroviral treatment: a case-control study.
OBJECTIVE
To compare post-cesarean complications between HIV-infected women on highly active antiretroviral therapy (HAART) and a matched group of non-HIV-infected women, and to evaluate predisposing risk factors for these complications in the HIV group.


METHODS
We performed a retrospective study of 160 HIV-infected women and 320 non-infected women who underwent cesarean section in a single reference center from 1997 to 2007. All HIV patients were under high active antiretroviral therapy (HAART). The women were assessed for a large number of major and minor postoperative complications. Selected risk factors for perioperative morbidity were analyzed in the HIV-positive group and data were analyzed using logistic regression.


RESULTS
Overall postoperative complications did not differ significantly between the two groups (26.9% in HIV patients vs. 22.8% in controls; OR = 1.24; 95% confidence interval [CI] = 0.8-1.92). Anemia was the most frequent morbidity observed, affecting 17.5% of HIV-positive women and 11.8% of controls. Major complications were associated with a CD4+ cell count of < 500 cell/ml (OR = 3.28, 95% CI = 1.04-10.31) and prematurity < 34 weeks (OR = 9.76, 95% CI = 1.99-47.71).


CONCLUSIONS
Post-cesarean complications were not significantly increased in HIV-infected women on HAART compared to non-HIV-infected women. Prematurity and low CD4+ cell count were risk factors for major complications.
Maiques
Vicente
V
Department of Obstetrics, Hospital Universitario La Fe, Valencia, Spain. agarciat@bellvitgehospital.cat
Garcia-Tejedor
Amparo
A
Diago
Vicente
V
Molina
José M
JM
Borras
Dolores
D
Perales-Puchalt
Alfredo
A
Perales
Alfredo
A
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D009017:Morbidity; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors