European Journal of Pediatrics

, Volume 154, Issue 7, pp 542–545 | Cite as

Mother-to-child transmission of human immunodeficiency virus type 1: Influence of parity and mode of delivery

  • Christian Kind
  • Paediatric AIDS Group of Switzerland
  • D. Nadal
  • C. -A. Wyler
  • C. -A. Siegrist
  • J. J. Cheseaux
  • B. Vaudaux
  • C. -L. Fawer
  • C. Rudin
  • U. B. Schaad
  • C. Aebi
  • C. Baumgartner
  • H. E. Gnehm
  • G. Schubiger
  • J. Klingler
  • U. Hunziker
  • H. F. Kuchler
  • M. P. Gianinazzi
  • U. Bühlmann
  • K. Biedermann
  • O. Irion
  • G. Spoletin
  • J. Schüpbach
  • J. Boni
  • J. Jendis
  • Z. Tomasik
Infectious Diseases Original Paper

Abstract

Abstract

In a national prospective study of risk factors for mother-tochild 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).

Conclusions

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.

Key words

HIV infections Infant newborn Pregnancy Parity Caesarean section 

Abbreviations

CI

confidence interval

HIV

human immunodeficiency virus type 1

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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Christian Kind
    • 18
  • Paediatric AIDS Group of Switzerland
  • D. Nadal
    • 1
  • C. -A. Wyler
    • 2
  • C. -A. Siegrist
    • 2
  • J. J. Cheseaux
    • 3
  • B. Vaudaux
    • 3
  • C. -L. Fawer
    • 3
  • C. Rudin
    • 4
  • U. B. Schaad
    • 4
  • C. Aebi
    • 5
  • C. Baumgartner
    • 6
  • H. E. Gnehm
    • 7
  • G. Schubiger
    • 8
  • J. Klingler
    • 9
  • U. Hunziker
    • 10
  • H. F. Kuchler
    • 11
  • M. P. Gianinazzi
    • 12
  • U. Bühlmann
    • 13
  • K. Biedermann
    • 14
  • O. Irion
    • 15
  • G. Spoletin
    • 16
  • J. Schüpbach
    • 17
  • J. Boni
    • 17
  • J. Jendis
    • 17
  • Z. Tomasik
    • 17
  1. 1.University Children's HospitalZürich
  2. 2.University Children's HospitalGenève
  3. 3.University Children's HospitalLausanne
  4. 4.University Children's HosptialBasel
  5. 5.University Children's HospitalBern
  6. 6.Children's HospitalSt. Gallen
  7. 7.Children's HospitalAarau
  8. 8.Children's HospitalLuzern
  9. 9.Children's HospitalBiel
  10. 10.Division of PaediatricsKantonsspitalWinterthur
  11. 11.Division of PaediatricsHôpital CantonalSion
  12. 12.Division of PaediatricsOspedale CivicoLugano
  13. 13.Division of PaediatricsStadtspital TriemliZürich
  14. 14.University Women's HospitalZürich
  15. 15.University Women's HospitalGenève
  16. 16.University Women's HospitalLausanne
  17. 17.National Centre for RetrovirusesZürich
  18. 18.Abteilung für NeonatologieFrauenklinik, KantonsspitalSt. GallenSwitzerland

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