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M9490111.TXT
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1994-09-03
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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).