HIV in Newborns

A major concern for obstetricians is the best way to prevent a newborn from contracting HIV from its infected mother. Some doctors opt for an elective C-section to protect the child, but in low-risk pregnancies, the risk of transmitting HIV to a newborn is only 1 percent to 2 percent. A study supports the idea that uncomplicated labor and vaginal delivery does not increase the baby’s risk of contracting HIV from its mother.

Researcher from Johns Hopkins University and the National Institutes of Health studied white blood cells from the umbilical cords of 23 babies born by vaginal delivery or elective C-section. They also studied cells from eight babies born to mothers who had either a condition called chorioamnionitis or had preterm labor. Chorioamnionitis is a bacterial infection of the amniotic sac. None of the women had HIV.

Researchers then checked the level of white blood cell activity from the umbilical cords. They found the activity level was not affected by delivery method. When they added HIV to these cells in the laboratory, there also was no difference in their ability to be infected.

However, researchers report the babies born to mothers with the bacterial infection or who had preterm labor had different results. When HIV was introduced to the white blood cells in the laboratory, the virus grew quickly. Researchers say this means these infants could be at a higher risk for HIV transmission if born to HIV-infected mothers.

Lead researcher Helene Bernstein, M.D., Ph.D., says, “Physicians may want to consider these findings when caring for infants at risk for HIV transmission after these problems. Other potential implications for clinical practice may include more aggressive treatment of HIV-infected mothers with these prenatal conditions.”

SOURCE: Reported by Ivanhoe at the Society for Maternal-Fetal Medicines Annual Meeting in New Orleans