HIV infection and AIDS are complicated diseases that pose many difficult
questions. People have questions about what risks there may be of transmission
from a mother with HIV infection to a fetus. Use the following links to find further
information on this topic.
GENERAL INFORMATION
TRANSMISSION TO NEWBORN
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During pregnancy, the stage of maternal infection can affect perinatal
transmission rates. The greater the progression of disease in the mother, as
measured by viral load or CD4 cell counts, the more likely is transmission.
Other factors that may increase the risk include hemorrhage during labor,
vaginal delivery, duration of labor after the rupture of membranes, and some
obstetrical approaches. Amniocentesis or other invasive procedures before labor
are also factors that may increase the risk.
TRANSMISSION THROUGH NURSING
DRUG THERAPIES
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In 1994, a clinical trial showed that drug therapy with
zidovudine, or AZT, decreased transmission from pregnant mother to newborn. AZT
was given to women after their first trimester of pregnancy, intravenously
during labor and delivery, and was given to their infants for the first six
weeks of their lives.3 In countries where AZT is available, AZT therapy
increased dramatically after the report. In a follow-up study of 103 infants
whose infected mothers received AZT therapy and 453 infants whose mothers did
not, HIV transmission was 19 percent among those not using AZT but only 8
percent among those receiving therapy.
Currently, the cost of drugs such as AZT is prohibitively
expensive in most developing countries. Studies are testing new drugs and simpler
regimens that may curtail transmission at lower cost.(In January, a U.S. National Institutes of
Health advisory panel recommended that infected
mothers should continue taking AZT to reduce chances of infecting
their babies, despite a National Cancer Institute study that raises
questions about whether the drug may increase cancer risks. The
study found high doses of AZT increased lung, liver and skin cancers
in baby mice. However, there is no evidence of any human child
getting cancer after AZT treatment, and a study by the manufacturer
of AZT found no risk among mice from lower doses that would be
equivalent to those given pregnant women.)
Other research is testing treatments with a specially made immunoglobulin, which
contains antibodies to HIV. This immunoglobulin comes from infected
individuals, but it has been carefully treated to kill HIV and other
infectious agents. It theoretically should boost the immune systems of
pregnant mothers and infants, so that the virus is less likely to
be transmitted from mother to child.
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