Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Maternal-newborn human immunodeficiency virus infection in Harlem.
Arch Pediatr Adolesc Med. 1994 Aug;148(8):813-9. Unique Identifier : AIDSLINE MED/94319452 Nicholas SW; Bateman DA; Ng SK; Dedyo T; Heagarty MC; Department of Pediatrics, Harlem Hospital Center, College of; Physicians and Surgeons of Columbia University, New York, NY.
Abstract:
OBJECTIVE: To determine the prevalence of human immunodeficiency virus type 1 (HIV-1) infection and its association with illicit drug use for mothers being delivered of infants at an inner-city municipal hospital. METHODS: We anonymously tested the umbilical cord blood for HIV-1 antibody of 98.1% (2971/3028) of singleton infants with birth weight greater than 500 g born during 1989 and linked the results to a maternal-infant database from which all identifying information had been removed. RESULTS: Overall, HIV-1 seroprevalence was 3.3% (99/2971). Among HIV-1-seropositive mothers, 79% (78/99) gave no history of ever using injected drugs. Seropositivity for HIV-1 was independently associated with history of maternal cocaine use during pregnancy (odds ratio, 3.55; 95% confidence interval, 2.18, 5.78), history of ever using injected drugs (odds ratio, 6.02; 95% confidence interval, 3.14, 11.6), positive serologic test result for syphilis during pregnancy (odds ratio, 3.37; 95% confidence interval, 1.94, 5.88), and increasing maternal age per year (odds ratio, 1.04; 95% confidence interval, 1.00, 1.09). Voluntary testing programs failed to identify 71% (70/99) of all HIV-1-infected women. Infants placed into foster care were eight times more likely to be HIV-1 seropositive than those discharged to their mothers. CONCLUSIONS: Most HIV-1-infected mothers seem to have acquired the infection via heterosexual transmission rather than via injected drug use. Associations of maternal HIV-1 infection with cocaine use, syphilis, and increasing age probably operate through behaviors that increase maternal risk of exposure to an HIV-1-infected sexual partner or, in the case of syphilis, also through biologic factors that may predispose to HIV-1 transmission. The failure of voluntary testing to identify most HIV-1-infected mothers provides a strong rationale for routine HIV-1 testing during pregnancy and in the newborn period.
Keywords: Adult AIDS Serodiagnosis Confidence Intervals Female Fetal Blood Human HIV Antibodies/*ANALYSIS HIV Infections/BLOOD/*EPIDEMIOLOGY/*TRANSMISSION *HIV Seroprevalence *HIV-1 Infant, Newborn Logistic Models Maternal Age Medical Record Linkage New York City/EPIDEMIOLOGY Odds Ratio *Population Surveillance Pregnancy Pregnancy Complications, Infectious/BLOOD/*EPIDEMIOLOGY/*ETIOLOGY Risk Factors Seroepidemiologic Methods Sex Behavior Substance Abuse, Intravenous/*COMPLICATIONS Support, Non-U.S. Gov't JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
