title: Factors associated with mother-to-child transmission of the human immunodeficiency virus in Pernambuco, Brazil, 2000-2009.
abstract: OBJECTIVE
  To identify risk factors associated with mother-to-child transmission of HIV in the Brazilian state of Pernambuco.
  
  
  METHODS
  Retrospective cohort study with 1200 HIV-exposed children born in Pernambuco, registered up to the age of 2 months in a public programme to prevent vertical transmission. Univariate and multivariate logistic regression analyses were conducted for maternal and peripartum characteristics and prophylactic interventions, to identify risk factors for mother-to-child transmission of HIV.
  
  
  RESULTS
  The transmission rate was 9.16% (95% CI: 7.4-10.9). The following risk factors were independently associated with transmission: non-use of antiretroviral during pregnancy (OR: 7.8; 95% CI: 4.1-15); vaginal delivery (OR: 2.02; 95% CI: 1.2-3.4); prematurity (OR: 2.5; 95% CI: 1.3-4.7); and breastfeeding (OR: 2.6; 95% CI: 1.4-4.6).
  
  
  CONCLUSIONS
  This mother-to-child transmission rate is unacceptably high, as prophylactic interventions such as antiretroviral therapy and infant feeding formula are free of charge. Absence of antiretroviral therapy during pregnancy was the main risk factor. Therefore, early identification of exposed mothers and initiating prophylactic interventions are the main challenges for controlling transmission.
authors.affiliation: Department of Tropical Medicine, Federal University of Pernambuco, Recife, Brazil. pedroalves@doctor.com
authors.forename: Pedro Alves
authors.initials: PA
authors.lastname: da Cruz Gouveia
authors.forename: Gerlane Alves Pontes
authors.initials: GA
authors.lastname: da Silva
authors.forename: Maria
authors.initials: M
authors.lastname: de Fatima Pessoa Militão de Albuquerque
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D001942:Breast Feeding / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents