Infección por virus de inmunodeficiencia humana en la embarazada. Importancia del conocimiento de la infección en el embarazo y factores de riesgo en la transmisión perinatal / Human immunodeficiency virus infection in pregnant women. The importance of recognizing the infection during pregnancy and risk factors for perinatal transmission
Rev. méd. Chile
; 131(6): 633-640, jun. 2003.
Artigo
em Espanhol
| LILACS
| ID: lil-356092
Biblioteca responsável:
CL12.1
ABSTRACT
BACKGROUND:
Using adequate infection control measures, the rate of vertical transmission of human immunodeficiency virus (HIV) during pregnancy, has been reduced to 3 per cent in Chile.AIM:
To determine vertical transmission rate and risk factors associated to perinatal infection in pregnant women with known (KI) and unknown HIV infection (UI). PATIENTS ANDMETHODS:
HIV infected pregnant women whose deliveries were attended at the San Borja Arriaran Hospital were included. Antiretroviral therapy (ART) has been used since 1995 (Zidovudine 13 patients, biOtherapy 4 and triple therapy 14 patients). Newborns have received ART since 1995. Premature labor without evident cause, premature rupture of membranes, and rupture of membranes over 4 h before delivery were evaluated. Delivery was by elective cesarean section since 1993. Breast feeding was avoided. Pregnant women with UI (suspected disease after delivery due to child or mother pathology) did not received ART. Delivery and breast feeding were managed with common obstetrical-neonatal criteria.RESULTS:
Fifty three HIV infected pregnant women were studied (43 with KI and 10 with UI). Four children (36.4 per cent) from the KI group and seven (63.6 per cent from the UI group became infected. The global rate of vertical transmission among KI group was significantly lower than UI group 9.5 per cent (4/42) vs 70.0 per cent(7/10) p < 0.001. Using ART, this rate was further reduced to 6.5 per cent (2/31) and with bitherapy or triple therapy to 0 per cent (0/18). Breast feeding, vaginal delivery, premature delivery with no clinical cause, premature rupture of membranes, rupture of membranes longer than 4 h and lack of ART, were significantly more common in the UI group, compared with KI group.CONCLUSIONS:
Vertical transmission in pregnant women with KI is significantly lower compared with UI. Risk factors increasing HIV perinatal infection are breast feeding, lack of ART, vaginal delivery, premature rupture of membranes, rupture of membranes > 4 h and premature labor without a clinical cause.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Base de dados:
LILACS
Assunto principal:
Complicações Infecciosas na Gravidez
/
Infecções por HIV
/
Transmissão Vertical de Doenças Infecciosas
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
Limite:
Adulto
/
Criança
/
Feminino
/
Humanos
/
Lactente
/
Recém-Nascido
/
Gravidez
País/Região como assunto:
América do Sul
/
Chile
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2003
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Universidad de Chile/CL