Term labor management and outcomes in treated HIV-infected women without contraindications to vaginal delivery and matched controls

Abstract

Objective: To assess labor management and outcomes for treated HIV-infected pregnant women with no obstetric or virologic contraindications to vaginal delivery.

Method: A retrospective case-control study was conducted at a single center with 146 treated HIV-infected pregnant women without obstetric or virologic contraindications to vaginal delivery and 146 controls. Cases and controls were matched for parity, previous cesarean delivery, and geographic origin.

Results: The mode of delivery was similar in the 2 groups but the episiotomy rate was significantly lower among the HIV-infected women (29.6% vs 45.6%, P = 0.01), with no difference in mean birth weight, simple or complex perineal laceration rates or neonatal outcome. Postpartum morbidity was also similar for controls and HIV-infected women with a CD4(+) cell count of 200 cells/mL or higher. However, in the study group, postpartum morbidity was higher among those whose CD4(+) cell count was lower than this threshold (3.2% vs 22.2%, P = 0.007). No case of mother-to-child transmission of HIV occurred.

Conclusion: HIV-infected women with no contraindication to vaginal delivery seem to have the same labor outcomes as uninfected women.