Assessment of mode of delivery and predictors of emergency caesarean section among women living with<scp>HIV</scp>in a matched‐pair setting with women from the general population in Denmark, 2002−2014

Ørbæk, Mathilde; Thorsteinsson, Kristina; Helleberg, Marie; Moseholm, Ellen; Katzenstein, Terese L.; Storgaard, Merete; Johansen, Işik Somuncu; Pedersen, Gert Frølund; Weis, Nina; Lebech, Anne‐Mette

doi:10.1111/hiv.12519

Cited by 12 publications

(22 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate has been similar in Sweden and Norway, but slightly higher in Denmark (22%) [ 19 ]. Conversely, regarding the low rate of CS in the general population, a recent study from Denmark concerning WLWH 2002–2014 reported a high rate (67%) of CS [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Most women living with HIV can deliver vaginally—National data from Finland 1993–2013

et al. 2018

View full text Add to dashboard Cite

IntroductionVaginal delivery has been recommended for more than ten years for women living with HIV (WLWH) with good virological control. However, in Europe most WLWH still deliver by cesarean section (CS). Our aim was to assess the rate of vaginal delivery and the indications for CS in WLWH over 20 years in a setting of low overall CS rate.Materials and methodsThis was a retrospective study of all WLWH delivering in Finland 1993–2013. We identified the women by combining national health registers and extracted data from patient files.ResultsThe study comprised 212 women with 290 deliveries. Over 35% of the women delivered several children during the study years. During 2000–2013, with consistent viral load monitoring, 80.0% showed HIV viral loads <50 copies/mL in the last measurement preceding the delivery. Altogether 74.5% of all WLWH delivered vaginally and the rate of both elective CS and emergency CS was 12.8% each. For most CSs (63.5%) the indication was obstetrical, for 28.4% it was avoiding HIV transmission and for 0.7% it was mother’s request. In hospitals with less than ten HIV-related deliveries during the study period, the rate of elective CS was higher than in more experienced hospitals (22.7% versus 10.6% [p = 0.024]). No perinatal HIV transmissions occurred.ConclusionsMost WLWH can achieve good virological control and deliver vaginally. This will help them to maintain their future child bearing potential and reduce CS-related morbidity.

show abstract

Section: Introductionmentioning

confidence: 99%

Most women living with HIV can deliver vaginally—National data from Finland 1993–2013

et al. 2018

View full text Add to dashboard Cite

show abstract

“…There are approximately 1400, 1000 and 2800 WLWH in Denmark, Finland and Sweden, respectively, of whom 80% are of childbearing age 7–9. The majority of WLWH in Scandinavia are immigrants, mainly from sub-Saharan Africa, and HIV has mainly been transmitted by sexual contact 8 10. The healthcare system in the Nordic countries is tax-based and ensures universal access to both medical healthcare and many social support services 11.…”

Section: Introductionmentioning

confidence: 99%

“…National antenatal screening for all pregnant women has been implemented as an opt-out programme (eg, all women are screened unless they decline) 13. The proportion of WLWH that are diagnosed during pregnancy range between 18% to 37% 8 10. Treatment with cART has been recommended to all pregnant WLWH in Scandinavia since the late 1990’s and most women have an undetectable viral load at the time of delivery, resulting in a decreased risk of perinatal transmission to <1% 1 8 10 14.…”

Section: Introductionmentioning

confidence: 99%

“…The proportion of WLWH that are diagnosed during pregnancy range between 18% to 37% 8 10. Treatment with cART has been recommended to all pregnant WLWH in Scandinavia since the late 1990’s and most women have an undetectable viral load at the time of delivery, resulting in a decreased risk of perinatal transmission to <1% 1 8 10 14. Condomless sex without assistance from artificial reproductive technologies and vaginal delivery are recommended in well-treated WLWH 1–3 8 15.…”

Section: Introductionmentioning

confidence: 99%

“…Newborn treatment with prophylactic antiretroviral medicine lasts for 4 weeks after birth 8 14 16. The annual number of children born to WLWH in both Denmark and Finland has increased from 10 in the year 2000 to 45 in 2014, with no evidence of perinatal transmission of HIV if the mother has been well-treated with cART 1 8 10. In Sweden, approximately 60 to 80 children are born to WLWH each year 17…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Study protocol: becoming and being a mother living with HIV - a multicentre longitudinal mixed methods study among pregnant women living with HIV, non-pregnant women living with HIV and pregnant women not living with HIV in a high-income setting (the 2B MOM study)

et al. 2019

View full text Add to dashboard Cite

IntroductionThe success of combination antiretroviral therapy has decreased the risk of perinatal HIV transmission and normalised pregnancy in women living with HIV (WLWH). Despite these advances, WLWH still face complex medical and psychosocial issues during pregnancy and postpartum, and there is a gap of knowledge on the experiences of becoming and being a mother living with HIV in today’s context. The overall aim of this study is to investigate psychosocial outcomes and experiences of WLWH in Scandinavia during pregnancy and early motherhood.Methods and analysisThis is a multicentre longitudinal convergent mixed methods study consisting of a quantitative survey study, a qualitative interview study and a mixed methods analysis. The survey study aims to examine psychosocial outcomes of WLWH across the pregnancy – postpartum trajectory. Participants are pregnant WLWH living in Scandinavia. Two control groups of HIV-negative pregnant women and non-pregnant WLWH are also included. Data is collected in the third trimester, 3 and 6 months postpartum using standardised questionnaires. Statistical analysis will assess changes over time and identify predictors of adverse outcomes. The interview study seeks to understand experiences of pregnancy and becoming a mother while living with HIV. Pregnant WLWH who are enrolled in the survey study will be asked to participate in individual interviews in the third trimester and 6 months postpartum. Data will be analysed using narrative analysis. The survey and interview results will be merged in a mixed methods analysis to assess confirmation, expansion or discordance between the data sets.Ethics and disseminationApproval from the Danish Data Protection Agency (VD-2018–253), and the Finnish and Swedish Ethics Committees have been obtained (HUS/1330/2019 and Dnr: 2019–04451, respectively). Study results will be disseminated to patient organisations, through publications in peer-reviewed journals and at scientific conferences.

show abstract

Prenatal ultrasound screening and pregnancy outcomes in HIV-positive women in Germany: results from a retrospective single-center study at the Charité-Universitätsmedizin Berlin

Hofacker,

Weichert,

Feiterna-Sperling

et al. 2023

Arch Gynecol Obstet

View full text Add to dashboard Cite

Assessment of mode of delivery and predictors of emergency caesarean section among women living withHIVin a matched‐pair setting with women from the general population in Denmark, 2002−2014

Abstract: Increasing numbers of WLWH deliver vaginally. Despite virological suppression, more WLWH plan and deliver by ECS than WGP. WLWH had a twofold higher risk of EmCS compared with WGP.

Cited by 12 publications

References 36 publications

Most women living with HIV can deliver vaginally—National data from Finland 1993–2013

Most women living with HIV can deliver vaginally—National data from Finland 1993–2013

Study protocol: becoming and being a mother living with HIV - a multicentre longitudinal mixed methods study among pregnant women living with HIV, non-pregnant women living with HIV and pregnant women not living with HIV in a high-income setting (the 2B MOM study)

Prenatal ultrasound screening and pregnancy outcomes in HIV-positive women in Germany: results from a retrospective single-center study at the Charité-Universitätsmedizin Berlin

Contact Info

Product

Resources

About