Effect of Mode of Delivery & Method of Feeding on Risk of Mother to Child Transmission (MTCT) of HIV in Pregnant Women Registered Under the PPTCT Programme
- 1. Department of Obstetrics and Gynaecology, Netaji Subhash Chandra Bose Medical College, Jabalpur Madhya Pradesh, India
Description
Introduction: Mother-to-child transmission of HIV is a major route of new infections in children. MTCT is multifactorial and are affected by various factors including both virus and host factors. Identifying factors associated with MTCT of HIV will have paramount importance in eliminating new HIV infections among children. This study focuses on mode of delivery and method of feeding obtained by HIV positive mother and we will review how these 2 factors influence the risk of MTCT. Method: This was a retrospective observational study. For the study, analysis of data of pregnant women registered under the PPTCT programme from 2014 onwards upto their delivery and follow up of their babies upto 18 months post-delivery was done. Throughout the study period confidentiality was maintained. Results: This study showed that mode of delivery is not related to MTCT (p value- 0.348) while method of feeding significantly associated with risk of MTCT (p value- <0.0001). Among 103 HIV positive newborns, 78.6% HIV positive newborns delivered vaginally while 21.3% HIV positive delivered by caesarean section, and 90.2% HIV positive newborns were given mixed feed, 3.7% HIV positive newborns were on breast feed while 5.8% HIV positive newborns were given replacement feed. Conclusion: This study concluded that optimally managed HIV positive pregnant women can continue labor and deliver by vaginal route. C-section should be performed for obstetric indications only. Ideal method of feeding is replacement feed as it has no possibility of MTCT. In resource poor countries, exclusive breastfeeding is the best option. Mixed feeding should strictly be avoided.
Abstract (English)
Introduction: Mother-to-child transmission of HIV is a major route of new infections in children. MTCT is multifactorial and are affected by various factors including both virus and host factors. Identifying factors associated with MTCT of HIV will have paramount importance in eliminating new HIV infections among children. This study focuses on mode of delivery and method of feeding obtained by HIV positive mother and we will review how these 2 factors influence the risk of MTCT. Method: This was a retrospective observational study. For the study, analysis of data of pregnant women registered under the PPTCT programme from 2014 onwards upto their delivery and follow up of their babies upto 18 months post-delivery was done. Throughout the study period confidentiality was maintained. Results: This study showed that mode of delivery is not related to MTCT (p value- 0.348) while method of feeding significantly associated with risk of MTCT (p value- <0.0001). Among 103 HIV positive newborns, 78.6% HIV positive newborns delivered vaginally while 21.3% HIV positive delivered by caesarean section, and 90.2% HIV positive newborns were given mixed feed, 3.7% HIV positive newborns were on breast feed while 5.8% HIV positive newborns were given replacement feed. Conclusion: This study concluded that optimally managed HIV positive pregnant women can continue labor and deliver by vaginal route. C-section should be performed for obstetric indications only. Ideal method of feeding is replacement feed as it has no possibility of MTCT. In resource poor countries, exclusive breastfeeding is the best option. Mixed feeding should strictly be avoided.
Files
IJPCR,Vol14,Issue12,Article38.pdf
Files
(386.2 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:01419c3ee641072ee50c4c58c7c15f2e
|
386.2 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-11-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue12,Article38.pdf
- Development Status
- Active
References
- 1. http://naco.gov.in/sites/default/files/Na tional_Guidelines_for_PPTCT.pdf 2. http://naco.gov.in/prevention-parentchild-transmissionpptct 3. Siobhan Mark, Kellie E. Murphy, Stanley Read, Ari Bitnun, Mark H. Yudin, HIV Mother-to-Child Transmission, Mode of Delivery, and Duration of Rupture of Membranes: Experience in the Current Era, Infectious Diseases in Obstetrics and Gynecology, 2012; 5 pages. 4. Ngwende Stella & Gombe Notion & Midzi Stanley & Tshimanga Mufuta & Shambira Gerald & Chadambuka, Addmore. Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza Hospital, Zimbabwe, 2008. BMC public health. 2013; 13:1181. 5. Mittal M, Mall AK, Sharma YG. Maternal and fetal outcomes in HIV positive pregnant female. Int J Res Med Sci 2016;4:5237-40. 6. Arnold F. Sciences II for P, International M: Nutrition in India. International Institute for Population Sciences, 2009. 7. Jonathan Izudi, Pontius Apangu, Francis Bajunirwe, Edgar Mulogo, Vincent Batwala, High Baseline CD4 Count and Exclusive Breastfeeding Are Associated with Lower Rates of Mother to Child HIV Transmission in Northwestern Uganda: A Two-Year Retrospective Cohort Study, Advances in Public Health. 2018; 8 pages. 8. Peters H, Byrne L, De Ruiter A, Francis K, Harding K, Taylor GP, Tookey PA, Townsend CL. Duration of ruptured membranes and mother-to-child HIV transmission: a prospective populationbased surveillance study. BJOG. 2016 May;123(6):975-81. 9. Burusie A, Deyessa N. Determinants of Mother to Child HIV Transmission (HIV MTCT); A Case Control Study in Assela, Adama and Bishoftu Hospitals, Oromia Regional State, Ethiopia. Cell Dev Biol. 2015; 4: 1000152. 10. Estrada R. E. G., Bohorquez G. D. B., Burgos R. A. O., Mendonça M. J. M. de, Sabando C. M. M., Sabando A. J. M., Reyes J. D. S., & Solano O. A. Impact of bariatric surgery on the sexual health of the morbid obese. Journal of Medical Research and Health Sciences. 2022; 5(4): 1866–1875.