Hospitalization of children born to human immunodeficiency virus- infected women in Europe

Objective. To describe the pattern of inpatient hospital service use in the first 5 years of life of all children born to HIV-infected women in 10 pediatric centers of the European Collaborative Study. Background. Little information is available on the need for hospitalization of children born to HIV-infected women, especially those uninfected, despite the fact that they may be at risk of social deprivation and poor health because of family cicumstances. Methods. Data on 1189 children enrolled between 1986 and 1997 and followed prospectively since birth according to a standard protocol were analyzed. Results. This analysis included 151 HIV-infected and 811 uninfected children. One hundred forty (12%) infants had delayed postnatal discharge, mainly for drug withdrawal symptoms and prematurity. Uninfected children had 0.5 admission per 5 child years compared with 2.4 for infected children. From life table analysis, an estimated 48% of infected and 17% of uninfected children will have been admitted by age 12 months. Nearly 60% (3304 of 5604) of the total inpatient days of infected children occurred after AIDS diagnosis. Infected children were 4 times more likely to be hospitalized than uninfected children of the same age, and children with symptomatic mothers were 13 times more likely to be admitted for a nonmedical reason. Conclusions. Whereas hospitalization of infected children poses an expected burden on the health care system, the use of such services by uninfected children is largely explained by their social background and provides an argument for better support for families affected by HIV.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Increasing likelihood of further live births in HIV-infected women in recent years

Objective To examine how the subsequent childbearing of HIV-infected mothers enrolled in the European Collaborative Study (ECS) has changed over time and identify factors predictive of further childbearing. Design Prospective cohort study. Setting Centres in nine European countries included in the ECS, enrolled between end 1986 and November 2003. Population HIV-infected women (3911): 3693 with only one and 218 with subsequent live births. Methods Univariable and multivariable logistic regression analyses to obtain odds ratios (OR) and 95% confidence intervals (CI). Kaplan-Meier (KM) analyses to estimate cumulative proportions of women having a subsequent live birth. Main outcome measures Subsequent live birth. Results In multivariable analysis adjusting for time period, ethnicity, maternal age and parity, black women were more likely [adjusted odds ratio (AOR) 2.45; 95% CI, 1.75-3.43], and women > 30 years less likely (AOR 0.54, 0.37-0.80), to have a subsequent live birth. Time to subsequent live birth significantly shortened over time, with an estimated 2% of women having a subsequent live birth within 24 months of enrolment pre-1989 versus 14% in 2000-2003 (P < 0.001). Estimated time to subsequent live birth was shorter for black than for white women (P < 0.001). Conclusions The likelihood of subsequent live births substantially increased after 1995 and birth intervals were shorter in women on HAART and among black women. Numbers are currently too small to address the issue of advantages and disadvantages in the management of subsequent deliverie