Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery

Judette Louis, Mark B. Landon, Rebecca J. Gersnoviez, Kenneth J. Leveno, Catherine Y. Spong, Dwight J. Rouse, Atef H. Moawad, Michael W. Varner, Steve N. Caritis, Margaret Harper, Ronald J. Wapner, Menachem Miodovnik, Marshall Carpenter, Alan M. Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Susan M. Ramin, Brian M. Mercer

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE: To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection. METHODS: A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications. RESULTS: There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2). CONCLUSION: Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality. LEVEL OF EVIDENCE: II.

Original languageEnglish
Pages (from-to)385-390
Number of pages6
JournalObstetrics and Gynecology
Volume110
Issue number2 I
DOIs
StatePublished - Aug 1 2007
Externally publishedYes

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HIV
Morbidity
Mortality
Virus Diseases
Postpartum Period
Mothers
Endometritis
Maternal Death
Maternal Mortality
Intraoperative Complications
Blood Transfusion
Observational Studies
Sepsis
Pneumonia
Logistic Models
Odds Ratio
Confidence Intervals
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Louis, J., Landon, M. B., Gersnoviez, R. J., Leveno, K. J., Spong, C. Y., Rouse, D. J., ... Mercer, B. M. (2007). Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery. Obstetrics and Gynecology, 110(2 I), 385-390. https://doi.org/10.1097/01.AOG.0000275263.81272.fc

Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery. / Louis, Judette; Landon, Mark B.; Gersnoviez, Rebecca J.; Leveno, Kenneth J.; Spong, Catherine Y.; Rouse, Dwight J.; Moawad, Atef H.; Varner, Michael W.; Caritis, Steve N.; Harper, Margaret; Wapner, Ronald J.; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan M.; O'Sullivan, Mary J.; Sibai, Baha M.; Langer, Oded; Thorp, John M.; Ramin, Susan M.; Mercer, Brian M.

In: Obstetrics and Gynecology, Vol. 110, No. 2 I, 01.08.2007, p. 385-390.

Research output: Contribution to journalArticle

Louis, J, Landon, MB, Gersnoviez, RJ, Leveno, KJ, Spong, CY, Rouse, DJ, Moawad, AH, Varner, MW, Caritis, SN, Harper, M, Wapner, RJ, Miodovnik, M, Carpenter, M, Peaceman, AM, O'Sullivan, MJ, Sibai, BM, Langer, O, Thorp, JM, Ramin, SM & Mercer, BM 2007, 'Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery', Obstetrics and Gynecology, vol. 110, no. 2 I, pp. 385-390. https://doi.org/10.1097/01.AOG.0000275263.81272.fc
Louis, Judette ; Landon, Mark B. ; Gersnoviez, Rebecca J. ; Leveno, Kenneth J. ; Spong, Catherine Y. ; Rouse, Dwight J. ; Moawad, Atef H. ; Varner, Michael W. ; Caritis, Steve N. ; Harper, Margaret ; Wapner, Ronald J. ; Miodovnik, Menachem ; Carpenter, Marshall ; Peaceman, Alan M. ; O'Sullivan, Mary J. ; Sibai, Baha M. ; Langer, Oded ; Thorp, John M. ; Ramin, Susan M. ; Mercer, Brian M. / Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery. In: Obstetrics and Gynecology. 2007 ; Vol. 110, No. 2 I. pp. 385-390.
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T1 - Perioperative morbidity and mortality among human immunodeficiency virus-infected women undergoing cesarean delivery

AU - Louis, Judette

AU - Landon, Mark B.

AU - Gersnoviez, Rebecca J.

AU - Leveno, Kenneth J.

AU - Spong, Catherine Y.

AU - Rouse, Dwight J.

AU - Moawad, Atef H.

AU - Varner, Michael W.

AU - Caritis, Steve N.

AU - Harper, Margaret

AU - Wapner, Ronald J.

AU - Miodovnik, Menachem

AU - Carpenter, Marshall

AU - Peaceman, Alan M.

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Mercer, Brian M.

PY - 2007/8/1

Y1 - 2007/8/1

N2 - OBJECTIVE: To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection. METHODS: A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications. RESULTS: There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2). CONCLUSION: Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality. LEVEL OF EVIDENCE: II.

AB - OBJECTIVE: To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection. METHODS: A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications. RESULTS: There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2). CONCLUSION: Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality. LEVEL OF EVIDENCE: II.

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