       Document 0505
 DOCN  M9610505
 TI    Mother-to-child transmission of human immunodeficiency virus type 1:
       influence of parity and mode of delivery. Paediatric AIDS Group of
       Switzerland.
 DT    9601
 AU    Kind C; Abteilung fur Neonatologie, Frauenklinik, Kantonsspital, St.;
       Gallen, Switzerland.
 SO    Eur J Pediatr. 1995 Jul;154(7):542-5. Unique Identifier : AIDSLINE
       MED/96040199
 AB    In a national prospective study of risk factors for mother-to-child
       transmission of human immunodeficiency virus (HIV), 316 children of
       HIV-positive mothers were followed up for at least 6 months. Infection
       status was determined in 254 of them and 46 were found to be infected
       giving a transmission rate of 18.1%. Univariate analysis of potential
       risk factors for mother-to-child transmission showed an association
       between primiparity and increased transmission rate: odds ratio 2.2, 95%
       confidence interval (CI) 1.1-4.6, P < 0.05. Analysis by logistic
       regression confirmed this association (adjusted odds ratio 2.4) and
       showed, in addition, a negative association between transmission rate
       and elective Caesarean section (adjusted odds ratio 0.36, 95% CI
       0.13-0.97, P < 0.05). The effect of primiparity was less pronounced in
       combination with elective Caesarean section (odds ratio 1.7) than with
       other delivery modes (odds ratio 2.5, difference not significant).
       HIV-infected children were less likely to experience the birth of a
       younger sibling during the observation period than their uninfected
       counterparts (2 of 46 vs 27 of 208, P < 0.05 by logrank test).
       CONCLUSION: Primiparous women appear to transmit HIV to their children
       at a higher rate. This could be explained by increased intrapartum
       transmission because of longer and more complicated labour in primiparas
       and/or by a self-selection of women with lower risk of transmission
       among those deciding to have additional children.
 DE    Adult  *Cesarean Section  *Disease Transmission, Vertical  Extraction,
       Obstetrical  Female  Follow-Up Studies  Human  HIV Infections/PREVENTION
       & CONTROL/*TRANSMISSION  *HIV-1  Infant  Infant, Newborn  Male  Odds
       Ratio  *Parity  Pregnancy  Prospective Studies  Risk Factors  Support,
       Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

