Perioperative Morbidity and Mortality among Human Immunodeficiency Virus Infected Women Undergoing Cesarean Delivery

Citation

Louis, Judette M.; Landon, Mark B.; Gersnoviez, Rebecca J.; Leveno, Kenneth J.; Spong, Catherine Y.; Rouse, Dwight J.; Moawad, Atef H.; Varner, Michael W.; Caritis, Steve N.; & Harper, Margaret A., et al. (2007). Perioperative Morbidity and Mortality among Human Immunodeficiency Virus Infected Women Undergoing Cesarean Delivery. Obstetrics & Gynecology, 110(2), 285-290.

Abstract

OBJECTIVE: To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection.
METHODS: A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications.
RESULTS: There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2).
CONCLUSION: Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality.
LEVEL OF EVIDENCE: II.

Reference Type

Journal Article

Year Published

2007

Journal Title

Obstetrics & Gynecology

Author(s)

Louis, Judette M.
Landon, Mark B.
Gersnoviez, Rebecca J.
Leveno, Kenneth J.
Spong, Catherine Y.
Rouse, Dwight J.
Moawad, Atef H.
Varner, Michael W.
Caritis, Steve N.
Harper, Margaret A.
Wapner, Ronald J.
Miodovnik, Menachem
Carpenter, Marshall W.
Peaceman, Alan M.
O'Sullivan, Mary Jo
Sibai, Baha M.
Langer, Oded
Thorp, John M., Jr.
Ramin, Susan M.
Mercer, Brian M., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

ORCiD

Thorp - 0000-0002-9307-6690