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Am J Obstet Gynecol. 2012 Dec;207(6):482.e1-5. doi: 10.1016/j.ajog.2012.10.862. Epub 2012 Oct 16.

Duration of membrane rupture and risk of perinatal transmission of HIV-1 in the era of combination antiretroviral therapy.

Author information

1
Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA. Amanda.Cotter@ul.ie

Abstract

OBJECTIVE:

The objective of the study was to determine whether the duration of membrane rupture of 4 or more hours is a significant risk factor for perinatal transmission of human immunodeficiency virus (HIV) in the era of combination antiretroviral therapy (ART).

STUDY DESIGN:

This was a prospective cohort study of 717 HIV-infected pregnant women-infant pairs with a delivery viral load available who received prenatal care and delivered at our institution during the interval 1996-2008.

RESULTS:

The cohort comprised 707 women receiving ART who delivered during this interval. The perinatal transmission rate was 1% in women with membranes ruptured for less than 4 hours and 1.9% when ruptured for 4 or more hours. For 493 women with a delivery viral load less than 1000 copies/mL receiving combination ART in pregnancy, there were no cases of perinatal transmission identified up to 25 hours of membrane rupture. Logistic regression demonstrated only a viral load above 10,000 copies/mL as an independent risk factor for perinatal transmission.

CONCLUSION:

Duration of membrane rupture of 4 or more hours is not a risk factor for perinatal transmission of HIV in women with a viral load less than 1000 copies/mL receiving combination ART.

PMID:
23103331
DOI:
10.1016/j.ajog.2012.10.862
[Indexed for MEDLINE]

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