Mode of delivery and neonatal respiratory morbidity among HIV-exposed newborns in Latin America and the Caribbean: NISDI Perinatal-LILAC Studies

Regis Kreitchmann, Rachel A. Cohen, Sonia K. Stoszek, Jorge A. Pinto, Marcelo Losso, Russell Pierre, Jorge Odon Alarcon Villaverde, Regina Succi, Edgardo Szyld, Thalita Abreu, Jennifer S. Read

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective: To evaluate respiratory morbidity (RM) in HIV-exposed newborns according to mode of delivery. Methods: The NISDI Perinatal/LILAC prospective cohort studies enrolled HIV-infected pregnant women and their newborns in Latin America and the Caribbean. Associations between RM and delivery mode or other characteristics were evaluated. Results: Between September 2002 and December 2009, 1630 women were enrolled, and 1443 mother-infant pairs met the inclusion criteria. There were 561 vaginal (VD), 269 cesarean before labor and membrane rupture (SCS) for preventing mother-to-child transmission (SCS-PMTCT), 248 other SCS, and 365 cesarean after labor and/or ruptured membranes (NSCS) deliveries. In total, 108 (7.5%) newborns had RM: 49 had respiratory distress syndrome (RDS), 39 had transient tachypnea (TTN), and 28 had other events (7 newborns had > 1 RM event). Delivery mode was associated with RDS (P < 0.005) and TTN (P < 0.001). The proportion with RDS and TTN was lowest for VD (1.6% and 0.5%, respectively), highest for NSCS (4.9% and 4.7%), and intermediate for SCS-PMTCT (3.0% and 2.6%). Newborns with RDS or TTN were hospitalized longer (median + 1 day) than those without. A minority required ventilatory support (RDS, 24.5%-28.6%; TTN, 2.6%-15.4%). Conclusions: SCS-PMTCT is relatively safe for newborns of HIV-infected women.

Original languageEnglish
Pages (from-to)91-96
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Volume114
Issue number2
DOIs
StatePublished - Aug 2011
Externally publishedYes

Bibliographical note

Funding Information:
Principal investigators , co-principal investigators , study coordinators, coordinating center representatives, and NICHD staff included: Argentina, Buenos Aires : Marcelo H. Losso , Irene Foradori, Claudia Checa, Silvina Ivalo (Hospital General de Agudos José María Ramos Mejía); Brazil, Belo Horizonte: Jorge Pinto , Victor Melo, Fabiana Kakehasi (Universidade Federal de Minas Gerais); Caxias do Sul: Ricardo da Silva de Souza , Nicole Golin , Sílvia Mariani Costamilan (Universidade de Caxias do Sul/ Serviço Municipal de Infectologia); Nova Iguacu: Jose Pilotto , Beatriz Grinsztejn, Valdilea Veloso, Gisely Falco (Hospital Geral Nova de Iguacu – HIV Family Care Clinic); Porto Alegre: Ricardo da Silva de Souza , Breno Riegel Santos, Rita de Cassia Alves Lira (Universidade de Caxias do Sul/Hospital Conceição); Ricardo da Silva de Souza , Mario Ferreira Peixoto , Elizabete Teles (Universidade de Caxias do Sul/Hospital Fêmina); Regis Kreitchmann , Luis Carlos Ribeiro, Fabrizio Motta, Debora Fernandes Coelho (Irmandade da Santa Casa de Misericordia de Porto Alegre); Ribeirão Preto: Marisa M. Mussi-Pinhata , Geraldo Duarte, Adriana A. Tiraboschi Bárbaro, Conrado Milani Coutinho, Anderson Sanches de Melo (Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo); Rio de Janeiro: Ricardo Hugo S. Oliveira , Elizabeth S. Machado, Maria C. Chermont Sapia (Instituto de Puericultura e Pediatria Martagão Gesteira); Esau Custodio Joao , Leon Claude Sidi, Ezequias Martins, Plinio Tostes Berardo (Hospital dos Servidores do Estado); São Paulo: Regina Celia de Menezes Succi , Prescilla Chow (Universidade Federal de São Paulo); Peru: Lima: Jorge Alarcón Villaverde (Instituto de Medicina Tropical “Daniel Alcides Carrión” – Sección de Epidemiología, UNMSM); Carlos Velásquez Vásquez (Instituto Nacional Materno Perinatal); César Gutiérrez Villafuerte (Instituto de Medicina Tropical “Daniel Alcides Carrión” – Sección de Epidemiología, UNMSM); Data Management and Statistical Center: Yolanda Bertucci, Laura Freimanis Hance, René Gonin, D. Robert Harris, Roslyn Hennessey, James Korelitz, Margot Krauss, Sharon Sothern de Sanchez, Sonia K. Stoszek (Westat, Rockville, MD, USA); NICHD: Rohan Hazra, Lynne Mofenson, Jennifer S. Read , Heather Watts, Carol Worrell ( Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA). Supported by NICHD Contract # N01-HD-3-3345 (2002–2007) and by NICHD Contract # HHSN267200800001C (NICHD Control #: N01-HD-8-0001) (2007–2012).

Keywords

  • Cesarean delivery
  • HIV
  • Newborn
  • Respiratory distress syndrome

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