American Journal of Obstetrics & Gynecology
Volume 172, Issue 2, Part 1 , Pages 700-705, February 1995

Risk factors for mother-to-child transmission of human immunodeficiency virus-1 infection☆

  • Marleen Temmerman, MD, PhD

      Affiliations

    • Corresponding Author InformationReprint requests: Marleen Temmerman, MD, PhD, Department of Obstetrics and Gynaecology, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
    • Departments of Medical Microbiology University of Nairobi, Nairobi, Kenya
    • Institute of Tropical Medicine, Antwerp, Belgium
    • ,
  • Aggrey O. Nyong'o, MD

      Affiliations

    • Department of Human Pathology, University of Nairobi, Nairobi, Kenya
    • ,
  • Joh Bwayo, MD

      Affiliations

    • Department of Human Pathology, University of Nairobi, Nairobi, Kenya
    • ,
  • Katrien Fransen, MSc

      Affiliations

    • Institute of Tropical Medicine, Antwerp, Belgium
    • ,
  • Mieke Coppens, MD

      Affiliations

    • Department of Pathology University Hospital Ghent, Belgium
    • ,
  • Peter Piot, MD, PhD

      Affiliations

    • Institute of Tropical Medicine, Antwerp, Belgium

Received 23 February 1994; received in revised form 23 June 1994; accepted 27 June 1994.

Abstract 

OBJECTIVE: Our aim was to examine maternal, obstetric, and infant characteristics of mother-to-child transmission of human immunodeficiency virus-1 in Nairobi, Kenya.

STUDY DESIGN: Proviral human immunodeficiency virus-1 was detected by polymerase chain reaction in peripheral blood samp0les taken between 6 weeks and 3 months of age from 107 children born to human immunodeficiency virus-1 seropositive women. The association of maternal, infant, and obstetric variables with human immunodeficiency virus-1 transmission was examined.

RESULTS: The mother-to-child transmission rate was 31% (95% confidence interval 21.6 to 40.2) as defined by the presence of proviral human immunodeficiency virus-1 in the infant. Variables associated with transmission in a univariate analysis included placental inflammation ( in the transmitting group as compared with in nontransmitters, p = 0.006), low maternal CD4 and high CD8 percentages (21% and 52%, respectively, in transmitting mothers and 32% and 40% in nontransmitting mothers; p = 0.001), and the gender of the neonates ( infected neonates were female as compared with noninfected children, p = 0.02). Sexually transmitted diseases were found more often in transmitting mothers but the differences were not significant. Birth weight and gestational age were not related to vertical transmission of human immunodeficiency virus-1.

CONCLUSION: Risk factors for mother-to-child transmission of human immunodeficiency virus-1 included chorioamnionitis, an impaired maternal immune status, and female gender.

Keywords:  Vertical transmission, human immunodeficiency virus-1, risk factors

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☆ Supported by grants from the Science and Technology for Developing Countries (STD) programme (contract No. TS2-M-0003-B) of the Commission of the European Communities, Brussels, Belgium, and the Global Program on AIDS, World Health Organization, Geneva, Switzerland.

PII: 0002-9378(95)90597-9

American Journal of Obstetrics & Gynecology
Volume 172, Issue 2, Part 1 , Pages 700-705, February 1995

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