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BJOG. 2016 May;123(6):975-81. doi: 10.1111/1471-0528.13442. Epub 2015 May 22.

Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study.

Author information

1
Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
2
Guys & St Thomas' NHS Foundation Trust, London, UK.
3
Imperial College Healthcare NHS Trust, London, UK.

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.

KEYWORDS:

Duration of ruptured membranes; HIV; mother-to-child transmission; pregnancy

PMID:
26011825
DOI:
10.1111/1471-0528.13442
[Indexed for MEDLINE]
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