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Titolo:
Mode of delivery and postpartum morbidity among HIV-infected women: The Women and Infants Transmission Study
Autore:
Read, JS; Tuomala, R; Kpamegan, E; Zorrilla, C; Landesman, S; Brown, G; Vajaranant, M; Hammill, H; Thompson, B;
Indirizzi:
NICHD, Adolescent & Maternal AIDS Branch, NIH, Bethesda, MD 20892 USA NICHD Bethesda MD USA 20892 rnal AIDS Branch, NIH, Bethesda, MD 20892 USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA CTASC, Baltimore, MD USA CTASC Baltimore MD USACTASC, Baltimore, MD USA Univ Puerto Rico, San Juan, PR 00936 USA Univ Puerto Rico San Juan PR USA00936 uerto Rico, San Juan, PR 00936 USA SUNY Hlth Sci Ctr, Brooklyn, NY 11203 USA SUNY Hlth Sci Ctr Brooklyn NY USA 11203 h Sci Ctr, Brooklyn, NY 11203 USA Columbia Univ, New York, NY USA Columbia Univ New York NY USAColumbia Univ, New York, NY USA Univ Illinois, Chicago, IL USA Univ Illinois Chicago IL USAUniv Illinois, Chicago, IL USA Baylor Coll Med, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ylor Coll Med, Houston, TX 77030 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 3, volume: 26, anno: 2001,
pagine: 236 - 245
SICI:
1525-4135(20010301)26:3<236:MODAPM>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
CESAREAN-SECTION; ANTIRETROVIRAL TREATMENT; MATERNAL COMPLICATIONS; PLACENTAL REMOVAL; POSITIVE WOMEN; RISK-FACTORS; ENDOMETRITIS; PROPHYLAXIS; AIDS;
Keywords:
postpartum morbidity; HIV infection; AIDS; mode of delivery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Read, JS NICHD, Adolescent & Maternal AIDS Branch, NIH, Execut Bldg,Room 4B11F,6100Execut Blvd MSC 7510, Bethesda, MD 20892 USA NICHD Execut Bldg,Room 4B11F,6100 Execut Blvd MSC 7510 Bethesda MD USA 20892
Citazione:
J.S. Read et al., "Mode of delivery and postpartum morbidity among HIV-infected women: The Women and Infants Transmission Study", J ACQ IMM D, 26(3), 2001, pp. 236-245

Abstract

Cesarean delivery before onset of labor and rupture of membranes (i.e., scheduled cesarean delivery) is associated with a lower risk of vertical transmission of HIV. The following a priori hypotheses were tested: among HIV-infected women, scheduled cesarean delivery is associated with a higher riskof postpartum morbidity, longer hospitalization, and a higher risk of rehospitalization than spontaneous vaginal delivery. Postpartum morbidity occurred following 178 of 1,186 (15%) of deliveries during 1990 to 1998 in The Women and Infants Transmission Study. The most commonly reported postpartum morbidity events were: fever without infection, hemorrhage or severe anemia, endometritis, urinary tract infection, and cesarean wound complications. Several time trends were observed: the median duration of ruptured membranes decreased (p < .001), intrapartum antibiotic use increased (p < .001), the median antepartum plasma HIV RNA concentration decreased (p < .001). and the incidence of any postpartum morbidity decreased (p = .02). With spontaneous vaginal delivery as the reference category, both scheduled (odds ratio[OR] = 4.69: 95% confidence interval [95% CI], 2.03-10.84), and nonscheduled (OR, 2.50; 95% CI, 1.24-5.04) cesarean deliveries were associated with fever without infection; with urinary tract infection (OR, 3.79; 95% CI 1.04-13.85; OR, 3.86; 95% CI, 1.55-9.60, respectively), and with any postpartummorbidity (OR, 3.19: 95% CI 1.69-6.00; OR, 4.10; 95% CI, 2.71-6.19, respectively). Nonscheduled cesarean deliveries were more likely to be complicated by endometritis (OR, 6.98: 95% CI, 3.53-13.78). Adjusted ORs relating mode of delivery and each of the outcomes (fever without infection, urinary tract infection, endometritis, and any postpartum morbidity) were similar to unadjusted ORs. Results of this analysis indicate scheduled cesarean delivery is associated with an increased risk of any postpartum morbidity and, specifically, postpartum fever without infection. The potential for postpartum morbidity with scheduled cesarean delivery should be considered in light of possible adverse events associated with other interventions to decrease the risk of vertical transmission of HIV. Counseling of HIV-infected pregnant women regarding scheduled cesarean delivery as a possible intervention to decrease maternal-infant transmission of HIV should include discussion ofthese results, as well as new data as they become available, regarding theincidence and severity of postpartum morbidity events among HIV-infected women according to mode of delivery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 12:40:28