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Factors associated with mother‐to‐child transmission of the human immunodeficiency virus in P ernambuco, B razil, 2000–2009
Author(s) -
da Cruz Gouveia Pedro Alves,
da Silva Gerlane Alves Pontes,
Fatima Pessoa Militão de Albuquerque Maria
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12042
Subject(s) - breastfeeding , medicine , transmission (telecommunications) , pregnancy , psychological intervention , obstetrics , logistic regression , risk factor , pediatrics , viral load , breast feeding , retrospective cohort study , immunology , human immunodeficiency virus (hiv) , biology , nursing , electrical engineering , engineering , genetics
Objective To identify risk factors associated with mother‐to‐child transmission of HIV in the B razilian state of P ernambuco. Methods Retrospective cohort study with 1200 HIV ‐exposed children born in Pernambuco, registered up to the age of 2 months in a public programme to prevent vertical transmission. Univariate and multivariate logistic regression analyses were conducted for maternal and peripartum characteristics and prophylactic interventions, to identify risk factors for mother‐to‐child transmission of HIV . Results The transmission rate was 9.16% (95% CI : 7.4–10.9). The following risk factors were independently associated with transmission: non‐use of antiretroviral during pregnancy ( OR : 7.8; 95% CI : 4.1–15); vaginal delivery ( OR : 2.02; 95% CI : 1.2–3.4); prematurity ( OR : 2.5; 95% CI : 1.3–4.7); and breastfeeding ( OR : 2.6; 95% CI : 1.4–4.6). Conclusions This mother‐to‐child transmission rate is unacceptably high, as prophylactic interventions such as antiretroviral therapy and infant feeding formula are free of charge. Absence of antiretroviral therapy during pregnancy was the main risk factor. Therefore, early identification of exposed mothers and initiating prophylactic interventions are the main challenges for controlling transmission.