Peters, H;
Byrne, L;
De Ruiter, A;
Francis, K;
Harding, K;
Taylor, GP;
Tookey, PA;
(2016)
Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study.
BJOG: An International Journal of Obstetrics & Gynaecology
, 123
(6)
pp. 975-981.
10.1111/1471-0528.13442.
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Abstract
OBJECTIVE: To investigate the association between duration of rupture of membranes (ROM) and mother-to-child HIV transmission (MTCT) rates in the era of combination antiretroviral therapy (cART). DESIGN: The National Study of HIV in Pregnancy and Childhood (NSHPC) undertakes comprehensive population-based surveillance of HIV in pregnant women and children. SETTING: UK and Ireland. POPULATION: A cohort of 2398 singleton pregnancies delivered vaginally, or by emergency caesarean section, in women on cART in pregnancy during the period 2007-2012 with information on duration of ROM; HIV infection status was available for 1898 infants. METHODS: Descriptive analysis of NSHPC data. MAIN OUTCOME MEASURES: Rates of MTCT. RESULTS: In 2116 pregnancies delivered at term, the median duration of ROM was 3 hours 30 minutes (interquartile range, IQR 1-8 hours). The overall MTCT rate for women delivering at term with duration of ROM ≥4 hours was 0.64% compared with 0.34% for ROM <4 hours, with no significant difference between the groups (OR 1.90, 95% CI 0.45-7.97). In women delivering at term with a viral load of <50 copies/ml, there was no evidence of a difference in MTCT rates with duration of ROM ≥4 hours, compared with <4 hours (0.14% for ≥4 hours versus 0.12% for <4 hour; OR 1.14, 95% CI 0.07-18.27). Among infants born preterm with infection status available, there were no transmissions in 163 deliveries where the maternal viral load was <50 copies/ml. CONCLUSIONS: No association was found between duration of ROM and MTCT in women taking cART. TWEETABLE ABSTRACT: Rupture of membranes of more than 4 hours is not associated with MTCT of HIV in women on effective ART delivering at term.
| Type: | Article |
|---|---|
| Title: | Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/1471-0528.13442 |
| Publisher version: | http://dx.doi.org/10.1111/1471-0528.13442 |
| Language: | English |
| Additional information: | This is the peer reviewed version of the following article: Peters, H; Byrne, L; De Ruiter, A; Francis, K; Harding, K; Taylor, GP; Tookey, PA; (2016) Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study. BJOG: An International Journal of Obstetrics & Gynaecology, 123 (6) pp. 975-981, which has been published in final form at: http://dx.doi.org/10.1111/1471-0528.13442. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html#terms). |
| Keywords: | Duration of ruptured membranes, HIV, mother-to-child transmission, pregnancy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1489605 |
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