Maternal and neonatal risk factors associated with increased mother-to-child transmission of HIV-1 in Mexico: Results of a case–control study

Abstract

Background Maternal, obstetric and neonatal factors that increase the possibility of mother-to-child HIV transmission (MTCT) are known as mechanisms of transmission. Our aim was to determine the risk factors associated with MTCT in Mexico. Methods We conducted a case–control study from March to December 2015. Cases were 60 mothers with HIV infection who transmitted HIV to their children, and controls were 120 mothers with HIV infection whose children tested negative for HIV. Data were extracted from medical records and a self-reported questionnaire for each participant. To determine associations with MTCT, odds ratios (ORs) and 95% confidence intervals (CI) were obtained with the chi-squared test and a logistic-regression modeling. Results A total of 180 patients were included. HIV diagnosis for cases occurred after pregnancy in 88% of the patients, during pregnancy in 9%, and before pregnancy in 3% of patients. Among the controls, 38% of patients were diagnosed before pregnancy, 32% during pregnancy, and 30% after pregnancy. In multivariate analysis, the risk factors associated with MTCT were: absence of antiretroviral treatment during pregnancy (OR 5.21; 95% CI 1.24–16.11; p = 0.019); vaginal delivery (OR 3.2; 95% CI 1.27–8.26; p = 0.014); forceps-assisted delivery (OR 13.4; 95% CI 1.91–93.66; p = 0.009); breastfeeding (OR 6.23; 95% CI 2.27–17.05; p = <0.001) and the practice of mixed breastfeeding (OR 4.6; 95% CI 1.56–13.73; p = 0.006). Conclusions MTCT is preventable with early diagnosis; treatment initiation before pregnancy and avoidance breastfeeding could decrease the risk of transmitting HIV to their children.

Roles of TGF-β1 in Viral Infection during Pregnancy: Research Update and Perspectives

“…However, most infants are infected during delivery. There are some factors increasing the MTCT risk, such as the absence of antiretroviral treatment during pregnancy, vaginal delivery, breastfeeding, maternal seroconversion during pregnancy or breastfeeding, high maternal plasma viral RNA load during pregnancy, and advanced maternal HIV disease [ 57 , 128 ]. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child ranges from 15% to over 40% [ 58 , 61 ].…”

Maternal Determinants of Prevention of Mother to Child Transmission of Human Immuno-deficiency Virus among Women in Homa Bay County Referral Hospital, Kenya

“…The advent of ART has provided a comprehensive platform through which HIV seropositive mothers can attain positive pregnancy outcomes aligned to giving birth to healthy HIV seronegative infants (José Antonio et al, 2022). However, despite the implementation of PMTCT strategies, the rate of transmission of HIV from mother to child in Kenya is 8.3% above the WHO target of less than 5% (UNAIDS, 2016).…”