About half of pregnant women with HIV have C-sections
Kartik K. Venkatesh, M.D., Ph.D., from the University of North Carolina in Chapel Hill, and colleagues examined factors associated with an HIV-indicated cesarean delivery versus other indications for pregnant women with HIV infection from 1998 to 2013.
Overall, 47 percent of the 6,444 pregnant women with HIV delivered by cesarean. The researchers found that there was an increase in cesarean delivery from 30 percent in 1998 to 48 percent in 2013. Repeat cesarean deliveries increased from 16 percent of all cesarean deliveries in 1998 to 42 percent in 2013; there was a peak in HIV-indicated cesarean deliveries at 48 percent in 2004, followed by a decrease to 12 percent by 2013. An HIV diagnosis during pregnancy, initiation of antiretroviral therapy in the third trimester, plasma viral load of ≥500 copies/mL, and delivery between 37 and 40 weeks were correlated with increased likelihood of HIV-indicated cesarean delivery in multivariable analysis. Over time, the likelihood of HIV-indicated cesarean delivery being associated with an HIV diagnosis during pregnancy, initiation of antiretroviral therapy in the third trimester, and a plasma load of ≥500 copies/mL increased progressively.
"Almost 50 percent of pregnant women with HIV infection underwent cesarean delivery," the authors write. "These findings reinforce the need for both early diagnosis and treatment of HIV infection in pregnancy and the option of vaginal delivery after cesarean among pregnant women with HIV infection."
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