Human immunodeficiency virus infection in women. I. The effects of human immunodeficiency virus on pregnancy

The clinical courses and initial neonatal outcomes of 50 patients with human immunodeficiency virus infection were followed on antepartum, intrapartum, and/or postpartum bases, between July 18, 1986, and December 27, 1987, at the University of Miami School of Medicine/Jackson Memorial Medical Center. The mean age at the time of the most recent delivery was 27 years. Cases attributable to the single risk factor of heterosexual transmission acounted for 76% of the cumulative number. Twenty-eight, or 56%, of the total sample were of Haitian ancestry. The patients in this study group did experience several complications of pregnancy. Interestingly, more than one third of the pregnancy courses (34.6%) were complicated by preterm labor. Only 15.4% of the patients had premature rupture of membranes. A higher rate of infection of the genitourinary tract and an increased incidence of sexually transmitted diseases in women known to be infected with human immunodeficiency virus are suggested. Less clear is the contribution of genitourinary tract infections and sexually transmitted diseases to the risk of acquired immunodeficiency syndrome or of perinatal human immunodeficiency virus transmission. Although a total of 10 patients in the study group were known to have children infected with human immunodeficiency virus, only longitudinal studies of the children of the mothers in this group will shed light on the number of children who ultimately become infected with human immunodeficiency virus. Similarly, although the majority of patients in this report remained asymptomatic during the course of their pregnancies, a matched, controlled study is necessary to confirm that pregnancy does not accelerate the progression of human immunodeficiency virus infection.