Document 0111
 DOCN  M9490111
 TI    Maternal-newborn human immunodeficiency virus infection in Harlem.
 DT    9411
 AU    Nicholas SW; Bateman DA; Ng SK; Dedyo T; Heagarty MC; Department of
       Pediatrics, Harlem Hospital Center, College of; Physicians and Surgeons
       of Columbia University, New York, NY.
 SO    Arch Pediatr Adolesc Med. 1994 Aug;148(8):813-9. Unique Identifier :
       AIDSLINE MED/94319452
 AB    OBJECTIVE: To determine the prevalence of human immunodeficiency virus
       type 1 (HIV-1) infection and its association with illicit drug use for
       mothers being delivered of infants at an inner-city municipal hospital.
       METHODS: We anonymously tested the umbilical cord blood for HIV-1
       antibody of 98.1% (2971/3028) of singleton infants with birth weight
       greater than 500 g born during 1989 and linked the results to a
       maternal-infant database from which all identifying information had been
       removed. RESULTS: Overall, HIV-1 seroprevalence was 3.3% (99/2971).
       Among HIV-1-seropositive mothers, 79% (78/99) gave no history of ever
       using injected drugs. Seropositivity for HIV-1 was independently
       associated with history of maternal cocaine use during pregnancy (odds
       ratio, 3.55; 95% confidence interval, 2.18, 5.78), history of ever using
       injected drugs (odds ratio, 6.02; 95% confidence interval, 3.14, 11.6),
       positive serologic test result for syphilis during pregnancy (odds
       ratio, 3.37; 95% confidence interval, 1.94, 5.88), and increasing
       maternal age per year (odds ratio, 1.04; 95% confidence interval, 1.00,
       1.09). Voluntary testing programs failed to identify 71% (70/99) of all
       HIV-1-infected women. Infants placed into foster care were eight times
       more likely to be HIV-1 seropositive than those discharged to their
       mothers. CONCLUSIONS: Most HIV-1-infected mothers seem to have acquired
       the infection via heterosexual transmission rather than via injected
       drug use. Associations of maternal HIV-1 infection with cocaine use,
       syphilis, and increasing age probably operate through behaviors that
       increase maternal risk of exposure to an HIV-1-infected sexual partner
       or, in the case of syphilis, also through biologic factors that may
       predispose to HIV-1 transmission. The failure of voluntary testing to
       identify most HIV-1-infected mothers provides a strong rationale for
       routine HIV-1 testing during pregnancy and in the newborn period.
 DE    Adult  AIDS Serodiagnosis  Confidence Intervals  Female  Fetal Blood
       Human  HIV Antibodies/*ANALYSIS  HIV
       Infections/BLOOD/*EPIDEMIOLOGY/*TRANSMISSION  *HIV Seroprevalence
       *HIV-1  Infant, Newborn  Logistic Models  Maternal Age  Medical Record
       Linkage  New York City/EPIDEMIOLOGY  Odds Ratio  *Population
       Surveillance  Pregnancy  Pregnancy Complications,
       Infectious/BLOOD/*EPIDEMIOLOGY/*ETIOLOGY  Risk Factors
       Seroepidemiologic Methods  Sex Behavior  Substance Abuse,
       Intravenous/*COMPLICATIONS  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).