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Title: Mode of delivery and neonatal respiratory morbidity among HIV-exposed newborns in Latin America and the Caribbean: NISDI Perinatal-LILAC Studies
Authors: Kreitchmann, Regis
Cohen, Rachel A.
Stoszek, Sonia K.
Pinto, Jorge A.
Losso, Marcelo
Pierre, Russell
Alarcon, Jorge
Succi, Regina [UNIFESP]
Szyld, Edgardo
Abreu, Thalita
Read, Jennifer S.
Irmandade Santa Casa de Misericordia Porto Alegre
Westat Corp
Universidade Federal de Minas Gerais (UFMG)
Hosp Gen Agudos Jose Maria Ramos Mejia
Univ W Indies
Univ San Marcos
Universidade Federal de São Paulo (UNIFESP)
Hosp Diego Paroissien
Universidade Federal do Rio de Janeiro (UFRJ)
Keywords: Cesarean delivery
Respiratory distress syndrome
Issue Date: 1-Aug-2011
Publisher: Elsevier B.V.
Citation: International Journal of Gynecology & Obstetrics. Clare: Elsevier B.V., v. 114, n. 2, p. 91-96, 2011.
Abstract: Objective: To evaluate respiratory morbidity (RM) in HIV-exposed newborns according to mode of delivery. Methods: the NISDI Perinatal/LILAC prospective cohort studies enrolled HIV-infected pregnant women and their newborns in Latin America and the Caribbean. Associations between RM and delivery mode or other characteristics were evaluated. Results: Between September 2002 and December 2009, 1630 women were enrolled, and 1443 mother-infant pairs met the inclusion criteria. There were 561 vaginal (VD). 269 cesarean before labor and membrane rupture (SCS) for preventing mother-to-child transmission (SCS-PMTCT), 248 other SCS, and 365 cesarean after labor and/or ruptured membranes (NSCS) deliveries. in total, 108 (7.5%) newborns had RM: 49 had respiratory distress syndrome (RDS), 39 had transient tachypnea (ITN), and 28 had other events (7 newborns had >1 RM event). Delivery mode was associated with RDS (P<0.005) and TIN (P<0.001). the proportion with RDS and UN was lowest for VD (1.6% and 0.5%, respectively), highest for NSCS (4.9% and 4.7%), and intermediate for SCS-PMTCT (3.0% and 2.6%). Newborns with RDS or TIN were hospitalized longer (median +1 day) than those without. A minority required ventilatory support (RDS, 24.5%-28.6%; UN, 2.6%-15.4%). Conclusions: SCS-PMTCT is relatively safe for newborns of HIV-infected women. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
ISSN: 0020-7292
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