Search

Your search keyword '"Penn, Z"' showing total 28 results
Start Over Author "Penn, Z"
28 results on '"Penn, Z"'

3. Duration of ruptured membranes and vertical transmission of HIV-1: a meta-analysis from 15 prospective cohort studies

Author

Bulterys, M. B., Fowler, M. G., Hanson, I. C., Lemay, M., Mayaux, M. J., Mofenson, L., Newell, M. -L., Peavy, H., Peckham, C., Read, J. S., Rother, C., Simpson, B. J., Van Dyke, R. B., Harris, D. R., Peavy, H. H., Easley, K., Khammy, A., Nugent, R. P., Mitchell, R., Owen, W., Van Dyke, R., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Krogstad, P., Mullins, J., Wolinsky, S., Korber, B., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Lapointe, N., Boucher, M., Fauvel, M., Hankins, C., Samson, J., Newell, M. L., Peckham, C. S., Thorne, C. N., Giaquinto, C., Ruga, E., De Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., de Alba, C., Garcia Rodriguez, M. C., Bates, I., de Josee, I., Hawkins, F., Martinez Zapico, R., Pena, J. M., Gonzalez Garcia, J., Arribas Lopez, J. R., Asensi-Botet, F., Otero, M. C., Peerez-Tamarit, D., Moya, A., Galbis, M. J., Scherpbier, H., Boer, K., Bohlin, A. B., Lindgren, S., Anzen, B., Belfrage, E., Lidin-Jansson, G., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Ferrazin, A., De Maria, A., Gotta, C., Mur, A., Vinolas, M., Paya, A., Loepez-Vilchez, M. A., Coll, O., Fortuny, C., Boguna, J., Casellas Caro, M., Canet, Y., Pardi, G., Ravizza, M., Semprini, E., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Zanelli, S., Duse, M., Soresina, A., Scaravelli, G., Stegagno, M., De Santis, M., Muggiasca, M. L., Vigano, A., Spinillo, A., Ravagni Probizer, F., Bucceri, A., Rancilio, L., Taylor, G. P., Lyall, H., Penn, Z., Blott, M., Valerius, N. H., Martinelli, P., Buffolano, W., Tibaldi, C., Ziarati, N., Semprini, A., Della Torre, M., Parazzini, F., Dallacasa, P., Bianchi, U., Pachi, A., Mancuso, S., Villa, P., Conti, M., Principi, N., Muggiasca, M., Marchisio, P., Zara, C., Ravagni, F., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tadrist, B., Thevenieau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, N., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J., Delattre, P., Stien, L., Audibert, F., Labrune, P., Vial, M., Mazy, F., Sitbon, D., Crenn-Hebert, C., Floch-Tudal, C., Akakpo, R., Daveau, C., Leblanc, A., Cesbron, P., Duval-Arnould, M., Huraux-Rendu, C., Lemerle, S., Touboul, C., Guerin, M., Maingueneau, C., Reynaud, I., Rousseau, T., Ercoil, V., Lanza, M., Denavit, M., Garnier, J., Lahsinat, K., Pia, P., Allouche, C., Nardou, M., Grall, F., May, A., Dallot, M., Lhuillier, P., Cecile, W., Mezin, R., Bech, A., Lobut, J., Algava, G., Chalvon Dermesay, A., Busuttil, R., Jacquemot, M., Bader-Meunier, B., Fridman, S., Codaccioni, X., Maxingue, F., Thomas, D., Alain, J., De Lumley, L., Tabaste, J., Bailly Salin, P., Seaume, H., Guichard, A., Kebaill, K., Roussouly, C., Botto, C., De Lanete, A., Wipff, P., Cravello, L., De Boisse, P., Leclaire, M., Michel, G., Crumiere, C., Lefevre, V., Le Lorier, B., Pauly, I., Robichez, B., Seguy, D., Delhinger, M., Rideau, F., Talon, P., Benos, P., Huret, C., Nicolas, J., Heller-Roussin, B., Saint-Leger, S., Delaporte, M., Hubert, C., De Sarcus, B., Karoubi, P., Mechinaud, F., Bertcrottiere, D., Bongain, A., Monpoux, F., De Gennes, C., Devianne, F., Nisand, I., Rousset, M., Mouchnino, G., Muray, J., Munzer, M., Quereux, C., Brossard, V., Clavier, B., Allemon, M., Rotten, D., Stephan, J., Varlet, M., Guyot, B., Narcy, P., Bardinet, F., De Caunes, F., Jeny, R., Robin, M., Raison Boulley, A., Savey, L., Berrebi, A., Tricoire, J., Borderon, J., Fignon, A., Guillot, F., Maria, B., Broyard, A., Chitrit, Y., Firtion, G., Mandelbrot, L., Lafay Pillet, M., Parat, S., Boissinot, C., Garec, N., Levine, M., Ottenwalter, A., Schaller, F., Vilmer, E., Courpotin, C., Brunner, C., Ciraru-Vigneron, N., Hatem-Gantzer, G., Fritel, X., Wallet, A., Bouille, J., Milliez, J., Bensaid Mrejen, D., Dermer, E., Noseda, G., Bardou, D., Cressaty, J., Francoual, C., Carlus Moncomble, C., Cohen, H., Blanche, S., Bastion, H., Benifla, J., Benkhatar, F., Berkane, N., Hervee, F., Ronzier, M., Mayaux, Mj., de Martino, M., Tovo, P. -A., Galli, L., Gabiano, C., Ferraris, G., Garetto, S., Palomba, E., Riva, C., Vierucci, A., de Luca, M., Farina, S., Fundaro, C., Genovese, O., Mereu, G., Forni, G. L., Casadei, A., Zuccotti, G. V., Riva, E., Cellini, M., Baraldi, C., Consolini, R., Palla, G., Ruggeri, M., Ciccimarra, F., Guarino, A., Osimani, P., Benaglia, G., Romano, A., De Mattia, D., Caselli, D., Boni, S., Dell'Erba, G., Bassanetti, F., Sticca, M., Timpano, C., Magnani, C., Salvatore, C., Lipreri, R., Tornaghi, R., Pinzani, R., Cecchi, M. T., Bezzi, T., Battisti, L., Bresciani, E., Castelli Gattinara, G., Nasi, C., Pellegatta, A., Mazza, A., Baldi, F., Altobelli, R., Deiana, M., Colnaghi, C., Tarallo, L., Tondo, U., Anastasio, E., Chiriaco, P. G., Ruggeri, C., Scott, G., Hutto, C., O'Sullivan, M., Malmsberry, A., Willoughby, A., Burns, D., Goedert, J., Landesman, S., Minkoff, H., Mendez, H., Holman, S., Rubinstein, A., Durako, S., Muenz, L., Goodwin, S., Bryson, Y., Dillon, M., Nielsen, K., Boyer, P., Liao, D., Keller, M., Deveikis, A., Nesheim, S., Lindsay, M., Lee, F., Nahmias, A., Sawyer, M., Vink, P., Farley, J., Alger, L., Abrams, E., Bamji, M., Lambert, G., Schoenbaum, E., Thomas, P., Weedon, J., Palumbo, P., Denny, T., Oleske, J., Bulterys, M., Simonds, R., Ethier-Ives, J., Rogers, M., Schluchter, M., Kutner, M., Kaplan, S., Kattan, M., Lipshultz, S., Mellins, R., Shearer, W., Sopko, G., Sloand, E., Wu, M., Kind, C., Nadal, D., Rudin, C., Siegrist, C. -A., Wyler, C. -A., Cheseaux, J. -J., Aebi, C., Gnehm, H., Schubiger, G., Klingler, J., Hunziker, U., Kuchler, H., Gianinazzi, M., Buhlmann, U., Biedermann, K., Lauper, U., Irion, O., Brunelli, A., Spoletini, G., Schreyer, A., Hosli, I., Saurenmann, E., Drack, G., Isenschmid, M., Poorbeik, M., Schupbach, J., Perrin, L., Erb, P., Joller, H., Kovacs, A., Stek, A., Chan, L., Khoury, M., Diaz, C., Pacheco-Acosta, E., Tuomala, R., Cooper, E., Mesthene, D., Pitt, J., Higgins, A., Moroso, G., Rich, K., Turpin, D., Cooper, N., Davenny, K., Thompson, B., Andiman, W., Simpson, J., THE INTERNATIONAL PERINATAL HIV, Group, Martinelli, Pasquale, Bulterys M.B., Fowler M.G., Hanson I.C., Lemay M., Mayaux M.J., Mofenson L., Newell M.-L., Peavy H., Peckham C., Read J.S., Rother C., Simpson B.J., Van Dyke R.B., Harris D.R., Peavy H.H., Easley K., Khammy A., Nugent R.P., Mitchell R., Owen W., Van Dyke R., Widmayer S., Bardeguez A., Hanson C., Wiznia A., Luzuriaga K., Viscarello R., Ho D., Koup R., Chen I., Krogstad P., Mullins J., Wolinsky S., Korber B., Walker B., Ammann A., Clapp S., McDonald D., Lapointe N., Boucher M., Fauvel M., Hankins C., Samson J., Newell M.L., Peckham C.S., Thorne C.N., Giaquinto C., Ruga E., De Rossi A., Truscia D., Grosch-Worner I., Schafer A., Mok J., Johnstone F., Jiminez J., de Alba C., Garcia Rodriguez M.C., Bates I., de Josee I., Hawkins F., Martinez Zapico R., Pena J.M., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Peerez-Tamarit D., Moya A., Galbis M.J., Scherpbier H., Boer K., Bohlin A.B., Lindgren S., Anzen B., Belfrage E., Lidin-Jansson G., Levy J., Barlow P., Hainaut M., Peltier A., Ferrazin A., De Maria A., Gotta C., Mur A., Vinolas M., Paya A., Loepez-Vilchez M.A., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Semprini E., Castagna C., Fiore S., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Zanelli S., Duse M., Soresina A., Scaravelli G., Stegagno M., De Santis M., Muggiasca M.L., Vigano A., Spinillo A., Ravagni Probizer F., Bucceri A., Rancilio L., Taylor G.P., Lyall H., Penn Z., Blott M., Valerius N.H., Martinelli P., Buffolano W., Tibaldi C., Ziarati N., Semprini A., Della Torre M., Parazzini F., Dallacasa P., Bianchi U., Pachi A., Mancuso S., Villa P., Conti M., Principi N., Muggiasca M., Marchisio P., Zara C., Ravagni F., Vignali M., Rossi G., Selvaggi L., Greco P., Vimercati A., Massi G., Innocenti T., Fiscella A., Sansone M., Benedetto C., Tadrist B., Thevenieau D., Gondry J., Paulard B., Alisy C., Brault D., Tordjeman N., Mamou J., Rozan M., Colombani D., Pincemaille O., Salvetti A., Chabanier C., Hernandorena X., Leroy J., Schaal J., Balde P., Faucher P., Lachassinne E., Benoit S., Douard D., Hocke C., Barjot P., Brouard J., Delattre P., Stien L., Audibert F., Labrune P., Vial M., Mazy F., Sitbon D., Crenn-Hebert C., Floch-Tudal C., Akakpo R., Daveau C., Leblanc A., Cesbron P., Duval-Arnould M., Huraux-Rendu C., Lemerle S., Touboul C., Guerin M., Maingueneau C., Reynaud I., Rousseau T., Ercoil V., Lanza M., Denavit M., Garnier J., Lahsinat K., Pia P., Allouche C., Nardou M., Grall F., May A., Dallot M., Lhuillier P., Cecile W., Mezin R., Bech A., Lobut J., Algava G., Chalvon Dermesay A., Busuttil R., Jacquemot M., Bader-Meunier B., Fridman S., Codaccioni X., Maxingue F., Thomas D., Alain J., De Lumley L., Tabaste J., Bailly Salin P., Seaume H., Guichard A., Kebaill K., Roussouly C., Botto C., De Lanete A., Wipff P., Cravello L., De Boisse P., Leclaire M., Michel G., Crumiere C., Lefevre V., Le Lorier B., Pauly I., Robichez B., Seguy D., Delhinger M., Rideau F., Talon P., Benos P., Huret C., Nicolas J., Heller-Roussin B., Saint-Leger S., Delaporte M., Hubert C., De Sarcus B., Karoubi P., Mechinaud F., Bertcrottiere D., Bongain A., Monpoux F., De Gennes C., Devianne F., Nisand I., Rousset M., Mouchnino G., Muray J., Munzer M., Quereux C., Brossard V., Clavier B., Allemon M., Rotten D., Stephan J., Varlet M., Guyot B., Narcy P., Bardinet F., De Caunes F., Jeny R., Robin M., Raison Boulley A., Savey L., Berrebi A., Tricoire J., Borderon J., Fignon A., Guillot F., Maria B., Broyard A., Chitrit Y., Firtion G., Mandelbrot L., Lafay Pillet M., Parat S., Boissinot C., Garec N., Levine M., Ottenwalter A., Schaller F., Vilmer E., Courpotin C., Brunner C., Ciraru-Vigneron N., Hatem-Gantzer G., Fritel X., Wallet A., Bouille J., Milliez J., Bensaid Mrejen D., Dermer E., Noseda G., Bardou D., Cressaty J., Francoual C., Carlus Moncomble C., Cohen H., Blanche S., Bastion H., Benifla J., Benkhatar F., Berkane N., Hervee F., Ronzier M., Mayaux MJ., de Martino M., Tovo P.-A., Galli L., Gabiano C., Ferraris G., Garetto S., Palomba E., Riva C., Vierucci A., de Luca M., Farina S., Fundaro C., Genovese O., Mereu G., Forni G.L., Casadei A., Zuccotti G.V., Riva E., Cellini M., Baraldi C., Consolini R., Palla G., Ruggeri M., Ciccimarra F., Guarino A., Osimani P., Benaglia G., Romano A., De Mattia D., Caselli D., Boni S., Dell'Erba G., Bassanetti F., Sticca M., Timpano C., Magnani C., Salvatore C., Lipreri R., Tornaghi R., Pinzani R., Cecchi M.T., Bezzi T., Battisti L., Bresciani E., Castelli Gattinara G., Nasi C., Pellegatta A., Mazza A., Baldi F., Altobelli R., Deiana M., Colnaghi C., Tarallo L., Tondo U., Anastasio E., Chiriaco P.G., Ruggeri C., Scott G., Hutto C., O'Sullivan M., Malmsberry A., Willoughby A., Burns D., Goedert J., Landesman S., Minkoff H., Mendez H., Holman S., Rubinstein A., Durako S., Muenz L., Goodwin S., Bryson Y., Dillon M., Nielsen K., Boyer P., Liao D., Keller M., Deveikis A., Nesheim S., Lindsay M., Lee F., Nahmias A., Sawyer M., Vink P., Farley J., Alger L., Abrams E., Bamji M., Lambert G., Schoenbaum E., Thomas P., Weedon J., Palumbo P., Denny T., Oleske J., Bulterys M., Simonds R., Ethier-Ives J., Rogers M., Schluchter M., Kutner M., Kaplan S., Kattan M., Lipshultz S., Mellins R., Shearer W., Sopko G., Sloand E., Wu M., Kind C., Nadal D., Rudin C., Siegrist C.-A., Wyler C.-A., Cheseaux J.-J., Aebi C., Gnehm H., Schubiger G., Klingler J., Hunziker U., Kuchler H., Gianinazzi M., Buhlmann U., Biedermann K., Lauper U., Irion O., Brunelli A., Spoletini G., Schreyer A., Hosli I., Saurenmann E., Drack G., Isenschmid M., Poorbeik M., Schupbach J., Perrin L., Erb P., Joller H., Kovacs A., Stek A., Chan L., Khoury M., Diaz C., Pacheco-Acosta E., Tuomala R., Cooper E., Mesthene D., Pitt J., Higgins A., Moroso G., Rich K., Turpin D., Cooper N., Davenny K., Thompson B., Andiman W., and Simpson J.

Subjects
Time Factors, Epidemiology, Infectious Disease Transmission, Prevention of perinatal transmission, Extraembryonic Membranes, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, Pregnancy, Risk Factors, INFECTION, Vertical, Immunology and Allergy, HIV Infection, MOTHER-TO-CHILD, Pregnancy Complications, Infectious, Prospective cohort study, prevention of perinatal transmission, vertical transmission, obstetrics/gynaecology, epidemiology, Obstetrics, Transmission (medicine), Infectious, HUMAN-IMMUNODEFICIENCY-VIRUS, MOTHER-TO-CHILD, ZIDOVUDINE PROPHYLAXIS, RISK-FACTORS, TYPE-1, PREGNANCY, INFECTION, TRIAL, PREVENTION, Breast Feeding, Infectious Diseases, Meta-analysis, HUMAN-IMMUNODEFICIENCY-VIRUS, Vertical transmission, Regression Analysis, TRIAL, Female, Delivery, Obstetrics gynaecology, Human, medicine.medical_specialty, Time Factor, Ruptured membranes, Immunology, Regression Analysi, NO, ZIDOVUDINE PROPHYLAXIS, Extraembryonic Membrane, medicine, Humans, TYPE-1, business.industry, Risk Factor, Infant, Newborn, Infant, Obstetric, Delivery, Obstetric, Newborn, PREVENTION, Infectious Disease Transmission, Vertical, Pregnancy Complications, Obstetrics/gynaecology, RISK-FACTORS, Cohort Studie, business
Abstract

Objective: To test the a priori hypothesis that longer duration of ruptured membranes is associated with increased risk of vertical transmission of HIV. Design: The relationship between duration of ruptured membranes and vertical transmission of HIV was evaluated in an individual patient data meta-analysis. Methods: Eligible studies were prospective cohort studies including at least 100 mother-child pairs, from regions where HIV-infected women are counselled not to breastfeed. Analyses were restricted to vaginal deliveries and non-elective Cesarean sections; elective Cesarean section deliveries (those performed before onset of labour and before rupture of membranes) were excluded. Results: The primary analysis included 4721 deliveries with duration of ruptured membranes ≤ 24 h. After adjusting for other factors known to be associated with vertical transmission using logistic regression analysis to assess the strength of the relationship, the risk of vertical HIV transmission increased approximately 2% with an increase of 1 h in the duration of ruptured membranes [adjusted odds ratio, 1.02; 95% confidence interval, 1.01-1.04; for each 1 h increment]. There were no significant interactions of duration of ruptured membranes with study cohort or with any of the covariates, except maternal AIDS. Among women diagnosed with AIDS, the estimated probability of transmission increased from 8% to 31% with duration of ruptured membranes of 2 h and 24 h respectively (P < 0.01). Conclusions: These results support the importance of duration of ruptured membranes as a risk factor for vertical transmission of HIV and suggest that a diagnosis of AIDS in the mother at the time of delivery may potentiate the effect of duration of ruptured membranes. © 2001 Lippincott Williams & Wilkins.

Published
2001

4. Combination antiretroviral therapy and duration of pregnancy

Author

Aebi, C, Battegay, M, Bernasconi, E, Biedermann, K, Cheseaux, JJ, Drack, G, Erb, P, Flepp, M, Francioli, P, Furrer, HJ, Gianinazzi, MP, Gyr, T, Hirschel, B, Hosli, I, Hug, I, Irion, O, Keller, K, Kind, C, Laubereau, B, Lauper, U, Lorenzi, P, Matter, L, Nadal, D, Perrin, L, Rickenbach, M, Rudin, C, Schreyer, A, Schupbach, J, Telenti, A, Vernazza, P, Wolf, K, Wunder, D, Wyler, CA, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Seel, K, Schafer, A, Mok, J, Johnstone, F, Jimenez, J, Garcia-Rodriguez, MC, Bates, I, de Jose, I, Hawkins, F, de Gevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Lidman, K, Christensson, B, Levy, J, Hainaut, M, Peltier, A, Barlow, P, Wibaut, S, Lecroart, MC, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Martinez-Gomez, P, Carreras, R, Coll, O, Fortuny-Guasch C, Boguna, J, Caro, MC, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, De Santis, M, Semprini, AE, Savasi, V, Vigano, A, Probizer, FR, Maccabruni, A, Bucceri, A, Rancilio, L, Taylor, GP, Lyall, H, Penn, Z, Valerius, NH, Martinelli, P, Buffolano, W, Sansone, M, Tibaldi, C, Ziarati, N, Benedetto, C, Niemiec, T, Horban, A, Newell M.-L., Aebi C., Battegay M., Bernasconi E., Biedermann K., Cheseaux J.-J., Drack G., Erb P., Flepp M., Francioli P., Furrer H.J., Gianinazzi M.-P., Gyr T., Hirschel B., Hosli I., Hug I., Irion O., Keller K., Kind C., Laubereau B., Lauper U., Lorenzi P., Matter L., Naddal D., Perrin L., Rickenbach M., Rudin C., Schreyer A., Schupbach J., Telenti A., Vernazza P., Wolf K., Wunder D., Wyler C.-A., Giaquinto C., Ruga E., De Rossi A., Grosh-Worner I., Seel K., Schafer A., Mok J., Johnstone F., Jimenez J., Garcia-Rodriguez M.C., Bates I., De Jose I., Hawkins F., Ladron de Gevara C., Ma Pena J., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Perez-Tamarit D., Ridaura S., Gregori P., De la Torre R., Scherpbier H., Kreyenbroek M., Boer K., Bohlin A.B., Lindgren S., Ehrnst A., Belfrage E., Lidman K., Christensson B., Levy J., Hainaut M., Peltier A., Barlow P., Wibaut S., Lecroart M.C., Ferrazin A., Bassetti D., De Maria A., Gotta C., Mur A., Paya A., Vinolas M., Lopez-Vilchez M.A., Martinez-Gomez P., Carreras R., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Duse M., Scaravelli G., Stegagno M., De Santis M., and Semprini A.E.

Subjects
Epidemiology, HIV Infections, Substance Abuse, Intravenou, Cohort Studies, Pregnancy, Immunology and Allergy, Medicine, HIV Infection, Prospective Studies, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, Prospective cohort study, Obstetrics, Infectious, Substance Abuse, Pregnancy Outcome, Gestational age, Viral Load, Antiretroviral therapy, Reverse Transcriptase Inhibitor, Infectious Diseases, Combination, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, Intravenous, Prematurity, Delivery, Zidovudine, Viral load, Infant, Premature, Human, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Combination therapy, Anti-HIV Agents, Immunology, CD4 Lymphocyte Count, Delivery, Obstetric, Gestational Age, HIV-1, Humans, Infant, Newborn, Drug Therapy, antiretroviral therapy, combination therapy, epidemiology, pregnancy, prematurity, Premature, business.industry, Infant, Anti-HIV Agent, Obstetric, Odds ratio, Newborn, medicine.disease, Surgery, Pregnancy Complications, Prospective Studie, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objective: To assess the association between type and timing of initiation of antiretroviral therapy in pregnancy and duration of pregnancy. Design: Prospective study. Methods: Data on 3920 mother child pairs were examined (3015 mother-child pairs from the European Collaborative Study and 905 from the Swiss Mother + Child HIV Cohort Study). Factors examined included gestational age, antiretroviral therapy during pregnancy, maternal CD4 count, viral load, illicit drug use (IDU) and mode of delivery. Deliveries at less than 37 weeks were defined as premature. Results: The prematurity rate was 17% and median gestational age 39 weeks. Twenty-three per cent (896 of 3920) of women received antiretroviral therapy during pregnancy: 64% (573 of 896) zidovudine monotherapy, 24% (215) combination therapy without protease inhibitors (PI) and 12% (108) combination therapy with PI. In multivariate analysis, adjusted for maternal CD4 count and IDU, odds ratio (OR) of prematurity was 2.60 195% confidence interval (CI), 1.43-4.751 and 1.82 (95% CI, 1.13-2.92) for infants exposed to combination therapy with and without a Pl, respectively, compared to no treatment. Exposure to monotherapy was not associated with prematurity, but severe immunosuppression and IDU in pregnancy were. Women on combination therapy from before pregnancy were twice as likely to deliver prematurely as those starting therapy in the third trimester (OR, 2.17 95% CI, 1.03-4.58). Conclusions: Pregnancy issues should be discussed when making decisions about initiation of combination antiretroviral therapy for HIV-infected women. Elective caesarean section to reduce vertical transmission at 36 weeks rather than 38 weeks may be advisable in women on combination therapy with PI. © 2000 Lippincott Williams & Wilkins.

Published
2000

5. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, GREGORI, PIETRO, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, LEVY, JOHANNA, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, DE MARIA, ANTONELLA, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, PEREZ, JESUS MARIA, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, BRAMBILLA, TERESA, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, Perez, JM, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, Brambilla, T, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, and Marczynska, M

Subjects
Europe, antiretroviral therapy, HIV, uninfected children, abnormalities
Abstract

Concerns have been raised over possible adverse effects of prophylactic antiretroviral therapy (ART) on the fetus and newborn. We analyzed data relating to uninfected children enrolled in the European Collaborative Study and investigated the association between ART exposure, perinatal problems, and major adverse health events later in life. Median length of follow-up was 2.2 (0-15.9) years. Of the 2414 uninfected children, 687 (28%) were exposed to ART in all three periods (antenatal, intrapartum, and neonatal). Of the 1008 infants exposed to ART at any time, 906 (90%) were exposed antenatally, 840 (83%) neonatally, and 750 (74%) both antenatally and neonatally. ART exposure was not significantly associated with pattern or prevalence of congenital abnormalities or low birth weight. In multivariate analysis, prematurity was associated with exposure to combination therapy without a protease inhibitor (PI) (OR = 2.66; 95% CI: 1.52-4.67) and with a PI (OR = 4.14; 95% CI: 2.36-7.23). ART exposure was associated with anemia in early life (P < .001). There was no evidence of an association with clinical manifestations suggestive of mitochondrial abnormalities. The absence of serious adverse events in this large cohort of uninfected children exposed to prophylactic ART in the short to medium term is reassuring.

Published
2004

6. Missed opportunities among HIV-positive women to control viral replication during pregnancy and to have a vaginal delivery

Author

Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Thorne, C, European Collaborative Study in EuroCoord, Swiss, Mother, Child HIV Cohort Study Collaborators: Thorne, C, Bailey, H, Giaquinto, C, Rampon, O, Mazza, A, De Rossi, A, Wörner, I, Mok, J, de José MI, Martínez, B, Peña, J, Garcia, J, Lopez, Jr, Rodriguez, Mc, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Payà, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, J, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Maso, G, Tropea, M, Barresi, V, Taylor, G, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, Chiara, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Aubert, V, Barth, J, Battegay, M, Bernasconi, E, Böni, J, Brazzola, P, Bucher, Hc, Burton Jeangros, C, Calmy, A, Cavassini, M, Cheseaux, Jj, Drack, G, Duppenthaler, A, Egger, M, Elzi, L, Fellay, J, Francini, K, Furrer, H, Fux, Ca, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, Hh, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kovari, H, Ledergerber, B, Martinetti, G, de Tejada, B, Metzner, K, Müller, N, Nadal, D, Pantaleo, G, Polli, Ch, Posfay Barbe, K, Rauch, A, Regenass, S, Schmid, P, Schultze, D, Schöni Affolter, F, Schüpbach, J, Speck, R, Taffé, P, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Wyler, Ca, Yerly, S., Posfay Barbe, Klara, Wyler, Claire-Anne, University of Zurich, Aebi-Popp, Karoline, Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Buffolano, Wilma, Thorne, C, European Collaborative Study in, Eurocoord, Swiss, Mother, and Child HIV Cohort, S. t. u. d. y.

Subjects
mode of delivery, medicine.medical_treatment, HIV Infections, Delivery, Obstetric/statistics & numerical data, Virus Replication, 10234 Clinic for Infectious Diseases, Cohort Studies, HIV Infections/drug therapy/prevention & control/transmission, Pregnancy, Antiretroviral Therapy, Highly Active, 2736 Pharmacology (medical), Pharmacology (medical), Surgical Procedures, Elective/statistics & numerical data, Pregnancy Complications, Infectious, Europe, HIV, Mode of delivery, Adult, Anti-HIV Agents, Cesarean Section, Delivery, Obstetric, Drug Therapy, Combination, Elective Surgical Procedures, Female, Guidelines as Topic, Health Policy, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Viral Load, Infectious Diseases, ddc:618, Obstetrics, Vaginal delivery, Transmission (medicine), Cesarean Section/statistics & numerical data, Meta-analysis, provvedimento amministrativo - nullità - domanda riconvenzionale, Viral load, Cohort study, medicine.medical_specialty, Pregnancy Complications, Infectious/drug therapy/epidemiology/prevention & control, 610 Medicine & health, Europe/epidemiology, Pharmacotherapy, medicine, Caesarean section, business.industry, 2725 Infectious Diseases, medicine.disease, Viral Load/drug effects, HIV, pregnancy, mode of delivery, Anti-HIV Agents/therapeutic use, Settore MED/40 - Ginecologia e Ostetricia, business, Infectious Disease Transmission, Vertical/prevention & control/statistics & numerical data
Abstract

INTRODUCTION: Most national guidelines for the prevention of mother-to-child transmission of HIV in Europe updated between 2001 and 2010 recommend vaginal deliveries for women with undetectable or very low viral load (VL). Our aim was to explore the impact of these new guidelines on the rates of vaginal deliveries among HIV-positive women in Europe. METHODS: In a pooled analysis of data on HIV-positive pregnant women enrolled in the Swiss Mother & Child HIV Cohort Study and the European Collaborative Study 2000 to 2010, deliveries were classified as occurring pre- or postpublication of national guidelines recommending vaginal delivery. RESULTS: Overall, 2663 women with 3013 deliveries were included from 10 countries; 28% women were diagnosed with HIV during pregnancy. Combination antiretroviral therapy was used in most pregnancies (2020, 73%), starting during the first or second trimester in 78% and during the third trimester in 22%; in 25% pregnancies, the woman conceived on combination antiretroviral therapy. Overall, in 86% pregnancies, a VL < 400 copies per milliliter was achieved before delivery. The proportion of vaginal deliveries increased from 17% (414/2377) before the change in guidelines to 52% (313/600) after; elective Caesarean section rates decreased from 65% to 27%. The proportion of women with undetectable VL having a Caesarean section was 55% after implementation of new guidelines. We observed a decrease of late preterm deliveries from 16% (377/2354) before to 7% (42/599) after the change in guidelines (P < 0.001). CONCLUSION: There are still missed opportunities for women with HIV to fully suppress their VL and to deliver vaginally in Europe.

Published
2013

7. Insufficient antiretroviral therapy in pregnancy: missed opportunities for prevention of mother-to-child transmission of HIV in Europe

Author

Bayley, H, Townsend, C, Cortina Borja, M, Thorne, C, Newell, Ml, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Grosch Wörner, I, Mok, J, de José MI, Larrú Martínez, B, Ma Peña, J, Gonzalez Garcia, J, Arribas Lopez JR, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Belfrage, E, Lindgren, S, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Pàya, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., European Collaborative Study in, Eurocoord, Buffolano, Wilma, Bailey, H, Townsend, C, Cortina Borja, M, Thorne, C., European Collaborative, Study, Martinelli, Pasquale, AII - Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, and Obstetrics and Gynaecology

Subjects
Adult, medicine.medical_specialty, Acquired Immunodeficiency Syndrome, HIV, Pregnancy, Antiviral Agents, antiretroviral therapy, Human immunodeficiency virus (HIV), HIV-1 infected women, mother-to-child transmission, risk factors, HIV Infections, medicine.disease_cause, Medical care, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Antiretroviral Therapy, Highly Active, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Disengagement theory, Pregnancy Complications, Infectious, Pharmacology, 030219 obstetrics & reproductive medicine, business.industry, mother-to-child transmission, Prevention of mother to child transmission, medicine.disease, Antiretroviral therapy, Infectious Disease Transmission, Vertical, 3. Good health, Europe, Infectious Diseases, Family medicine, Immunology, HIV-1, Female, business, HIV-1 infected women, Viral load
Abstract

Background Although mother-to-child transmission (MTCT) rates are at an all-time low in Western Europe, potentially preventable transmissions continue to occur. Duration of antenatal combination antiretroviral therapy (ART) is strongly associated with MTCT risk. Methods Data on pregnant HIV-infected women enrolled in the Western and Central European sites of the European Collaborative Study between January 2000 and July 2009 were analysed. The proportion of women receiving no antenatal ART or 1–13 days of treatment was investigated, and associated factors explored using logistic regression models. Results Of 2,148 women, 142 (7%) received no antenatal ART, decreasing from 8% in 2000–2003 to 5% in 2004– 2009 (χ2=8.73; PConclusions Over the last 10 years, around one in 11 women in this study received insufficient antenatal ART, accounting for 40% of MTCTs. One-half of these women were diagnosed before conception, suggesting disengagement from care.

Published
2011

8. Mode of delivery in HIV-infected pregnant women and prevention of mother-to-child transmission: changing practices in Western Europe

Author

Boer, K, England, K, Godfried, Mh, Thorne, C, Newell, Ml, Mahdavi, S, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Worner, Ig, Mok, J, DE JOSE MI, Martinez, Bl, Pena, Jm, Garcia, Jg, Lopez, Jra, Rodriguez, Mcg, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Scherpbier, Hj, Kreyenbroek, M, Nellen, Fjb, Naver, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, DE BRUYCKER JJ, Thiry, N, Waterloos, H, Viscoli, C, DE MARIA, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Savasi, V, Fiore, S, Crivelli, M, Vigano, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., Other Research, Obstetrics and Gynaecology, AII - Amsterdam institute for Infection and Immunity, General Internal Medicine, and Martinelli, Pasquale

Subjects
mode of delivery, HIV Infections, 0302 clinical medicine, prevention, Pregnancy, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Young adult, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, elective caesarean section, mode of delivery, mother-to-child transmission, prevention, 030219 obstetrics & reproductive medicine, pregnancy mother-to-child transmission, Vaginal delivery, Obstetrics, Health Policy, Prenatal Care, Viral Load, 3. Good health, Substance abuse, Europe, Infectious Diseases, Premature birth, Premature Birth, Reverse Transcriptase Inhibitors, Female, medicine.symptom, delivery, Viral load, Zidovudine, Adult, medicine.medical_specialty, elective caesarean section, Prenatal care, Article, 03 medical and health sciences, Young Adult, medicine, Humans, business.industry, Cesarean Section, mother-to-child transmission, HIV, Infant, Newborn, Infant, medicine.disease, Delivery, Obstetric, Infectious Disease Transmission, Vertical, Low birth weight, business, Epidemiologic Methods
Abstract

Objectives The aim of the study was to examine temporal and geographical patterns of mode of delivery in the European Collaborative Study (ECS), identify factors associated with elective caesarean section (CS) delivery in the highly active antiretroviral therapy (HAART) era and explore associations between mode of delivery and mother-to-child transmission (MTCT). Methods The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their infants prospectively followed. Data on 5238 mother-child pairs (MCPs) enrolled in Western European ECS sites between 1985 and 2007 were analysed. Results The elective CS rate increased from 16% in 1985-1993 to 67% in 1999-2001, declining to 51% by 2005-2007. In 2002-2004, 10% of infants were delivered vaginally, increasing to 34% by 2005-2007. During the HAART era, women in Belgium, the United Kingdom and the Netherlands were less likely to deliver by elective CS than those in Italy and Spain [adjusted odds ratio (AOR) 0.07; 95% confidence interval (CI) 0.04-0.12]. The MTCT rate in 2005-2007 was 1%. Among MCPs with maternal HIV RNA

Published
2010

9. Use of neonatal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV is decreasing in Western Europe

Author

England, K., Thorne, C., Giaquinto, C., Rampon, O., D’Elia, R., De Rossi, A., Grosch Wörner, I., Mok, J., de José, I., Laaru ́, A., Bates, I., Salas, A., Ma Peña, J., Gonzalez Garcia, J., Arribas Lo pez, J. R., Garcia Rodriguez, M. C., Asensi Botet, F., Otero, M. C., Pérez Tamarit, D., Scherpbier, H. J., Kreyenbroek, M., Godfried, M. H., Nellen, F. J. B., Boer, K., Bohlin, A. B., Lindgren, S., Anzén, B., Lidman, K., Elfgren, K., Gyllensten, K., Pehrson, P. O., Levy, J., Barlow, P., Manigart, Y., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., DE MARIA, Andrea, Bentivoglio, Giorgio, Ferrero, Simone, Gotta, C., Mur, A., Paya, A., López Vilchez, M. A., Carreras, R., Valerius, N. H., Rosenfeldt, V., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguña, J., Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., De Santis, M., Savasi, V., Fiore, S., Cri velli, M., Ferrazzi, E., Vigano`, A., Giacomet, V., Frasca, D., Zuccotti, G., Ravagni Probizer, F., Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Maruotti, G., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Marczynska, T. Niemiec ̧ M., Dobosz, S., Popielska, J., and Oldakowska, A.

Subjects
Microbiology (medical), Cart, Pediatrics, medicine.medical_specialty, antiretroviral therapy, HIV Infections, Chemoprevention, Article, Zidovudine, Pregnancy, Medicine, Humans, HIV, pregnancy, Maternal Transmission, business.industry, Infant, Newborn, medicine.disease, Infectious Disease Transmission, Vertical, Europe, Infectious Diseases, Chemoprophylaxis, Cohort, Observational study, Female, business, Viral load, medicine.drug
Abstract

To the Editor: Since the ACTG076 trial results were published in 1994 [1], antiretroviral prophylaxis for the neonate as well as during pregnancy and delivery has been the cornerstone of prevention of mother-to-child transmission (MTCT) of HIV. In the second decade of the combination antiretroviral therapy (cART) era, around 90% of pregnant HIV-infected women in Western Europe receive antenatal cART, for their own health and/or for prevention of MTCT (PMTCT) [2-4]. The rationale for including neonatal prophylaxis in the ACTG076 trial included uncertainty regarding timing of MTCT and the desire to boost the infant’s in utero and intrapartum antiretroviral drug exposure with 6 weeks zidovudine prophylaxis, as a post-exposure prophylaxis (PEP) for newborns not infected with HIV in utero. Observational studies and trials subsequently demonstrated effectiveness of neonatal PEP for infants whose mothers received no antiretroviral drugs [5-7]. No trial data exist comparing the efficacy of different neonatal prophylaxis regimens for infants of women on cART. We investigated trends in neonatal prophylaxis use in the cART era in Western European sites of the European Collaborative Study, a cohort of HIV-infected pregnant women and their children; full methods are described elsewhere [4]. Logistic regression was used to investigate factors associated with receipt of neonatal prophylaxis. Variables considered in the multivariable model were antenatal antiretroviral use, mode of delivery, country and year of delivery, prematurity (

Published
2009

10. The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West

Author

Giaquinto, C, Rampon, O, D'Elia, R, De Rossi, A, Grosch Worner, I, Feiterna Sperling, C, Schmitz, T, Casteleyn, S, Mok, J., de Jose, I, Bates, I, Larru, B, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Perez Tamarit, D, Suarez, G, Scherpbier, H, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Bohlin, Ab, Lindgren, S, Belfrage, E, Naver, L, Anzen, B, Lidman, K, Levy, J, Hainaut, M, Goetghebuer, T, Manigart, Y, Barlow, P, Ferrazin, A, Bassetti, D, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, Lopez Vilchez MA, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, Marzia, Scaravelli, G, Stegagno, M, De Santis, M, Savasi, V, Ferrazzi, E, Vigano, A, Giacomet, V, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Agangi, A, Tibaldi, C, and Marini, S.

Published
2006

11. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy

Author

Giaquinto, Carlo, Ruga, EZIA MARIA, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE, I, Bates, I, Hawkins, F, DE GUEVARA CL, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ MC, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT DP, Suarez, G, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, Ab, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Lidman, K, Anzen, B, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Goetghebuer, T, Ferrazin, A, Bassetti, D, DE MARIA, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, LOPEZ VILCHEZ MA, Rovira, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Caro, Mc, Canet, Y, Savasi, V, Vigano, A, Ferrazi, E, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Agangi, A, Sansone, M, Tibaldi, C, and Et, Al

Subjects
PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, RNA LEVELS, VERTICAL TRANSMISSION, CESAREAN DELIVERY, PREGNANT-WOMEN, PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, CESAREAN DELIVERY, RNA LEVELS, VERTICAL TRANSMISSION, PREGNANT-WOMEN
Published
2005

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

Author

Giaquinto, Carlo, Ruga, EZIA MARIA, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE, I, Bates, I, Hawkins, F, DE GUEVARA CL, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ MC, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Suarez, G, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, Ab, Lindgren, S, Belfrage, E, Naver, L, Anzen, B, Lidman, K, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Goetghebuer, T, Ferrazin, A, Bassetti, D, DE MARIA, A, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, DE SANTIS, M, Semprini, Ae, Savasi, V, Vigano, A, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, Dw, Tiseo, R, Martinelli, P, Sansone, M, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Horban, A., Agangi, A., theEUROPEAN COLLABORATIVE, Study, and Martinelli, Pasquale

Subjects
medicine.medical_specialty, Time Factors, Population, HIV Infections, Logistic regression, ANTIRETROVIRAL THERAPY, Pregnancy, Antiretroviral Therapy, Highly Active, Hiv infected, medicine, Humans, Pregnancy Complications, Infectious, Prospective cohort study, education, Reproductive History, VERTICAL TRANSMISSION, Gynecology, education.field_of_study, business.industry, Obstetrics and Gynecology, Odds ratio, IMMUNODEFICIENCY-VIRUS TYPE-1, IMMUNODEFICIENCY-VIRUS TYPE-1, ANTIRETROVIRAL THERAPY, VERTICAL TRANSMISSION, Confidence interval, Parity, Female, Epidemiologic Methods, business, Live birth, Parity (mathematics), Maternal Age, Demography
Abstract

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 enrollment 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 deliveries.

Published
2005

13. When do obstetricians recommend delivery for a high-risk preterm growth-retarded fetus? The GRIT Study Group. Growth Restriction Intervention Trial

Author

The GRIT Study Group, Danielian, P., Dawson, A., Whittle, M., Lilford, R. J., Tuffnell, D., Soothill, P., Beattie, B., Mires, G., Calder, A., Bashir, T., Lindow, S., Johal, W., Neales, K., Mason, G., Walker, J., Taylor, D., Narayan, H., Walkinshaw, S., Elder, M., Murphy, K., Manyonda, I., Bewley, S., Penn, Z., Rodeck, C., Griffiths, M., Maresh, M., Yousseff, H., Robson, S., Wiener, J., Hebblethwaite, N., Jenkinson, S., Fairlie, F., Fraser, R., Stewart, W., Johanson, R., James, D., Sengupta, B. S., Saunders, N., Cameron, H., Churchill, D., Bober, S., Heard, M., Welch, R., Pring, D., Gleeson, R., Jenkins, D., van Geijn, H., Amsterdam, V. U., Wolf, H., Visser, G., van Loon, A., van der Lugt, B., van der Slikke, J. W., van Roosmalen, J., Karpathios, S., Todros, Tullia, Frusca, T., Montanari, L., Ferrazzi, E., Garzetti, G., Tranquilli, A., Di Tommaso, R., Locci, M. V., Roncaglia, N., Tenore, A. C., Centini, G., Bricchi, G., Genazzani, A. R., Streda, R., Gjelland, K., Heikkila, A., Vasco, E., and Martin, T.

Subjects
Fetal Growth Retardation, Time Factors, Pregnancy, High-Risk, Infant, Newborn, Gestational Age, Pilot Projects, Intervention, Failure to thrive, Delivery, Obstetric, Umbilical Arteries, Pregnancy Complications, Preterm fetus, Intervention, Failure to thrive, Pregnancy, Laser-Doppler Flowmetry, Humans, Female, Preterm fetus, Infant, Premature
Abstract

Forty-nine obstetricians from three European countries were asked when they would advise delivery for a preterm fetus failing to thrive in utero, given various gestational ages, and a range of either umbilical artery Doppler flow velocity waveforms or CTG variability measures. Their responses indicated a wide area of disagreement about the correct timing of delivery, and a willingness to randomize patients to clinical trials of management. The area of uncertainty corresponded to the gestational age and Doppler bands at which participants have been entered to the pilot phase of a randomised trial of timed delivery, the Growth Restriction Intervention Trial (GRIT).

Published
1996

15. Using clinical evidence

Author

Knapp, M. S, primary, Gordon, S., additional, Lambert, M., additional, Ghaem-Maghami, S, additional, Khong, M. L., additional, Beski, S., additional, Penn, Z., additional, and Barton, S., additional

Published
2001
Full Text
View/download PDF

17. Levels and patterns of HIV RNA viral load in untreated pregnant women

Author

Patel, D, Thorne, C, Newell, Ml, CORTINA BORJA, M, Giaquinto, Carlo, Rampon, O, D'Elia, R, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE MI, Martinez, Bl, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ, J, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fjb, Boer, K, Ehrnst, A, Bohlin, Ab, Lindgren, S, Anzen, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Ferrazin, A, Viscoli, C, DE MARIA, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, DE SANTIS, M, Savasi, V, Fiore, S, Crivelli, M, Ferrazzi, E, Vigano, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, A, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T, Posokhova, S, Kaleeva, T, Stelmah, A, Kiseleva, G., European Collaborative Study, Patel D, Thorne C, Newell ML, Cortina-Borja M [, Guerra B, Lanari M ], Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, and Obstetrics and Gynaecology

Subjects
Microbiology (medical), Adult, medicine.medical_specialty, Race, Adolescent, Black People, Gestational Age, HIV Infections, Disease, White People, HIV, Pregnancy, HIV RNA viral load, ART-naïve, Young Adult, Asian People, pregnancy, Medicine, Humans, Young adult, Pregnancy Complications, Infectious, business.industry, Obstetrics, Confounding, RNA, Gestational age, General Medicine, Viral Load, medicine.disease, CD4 Lymphocyte Count, hiv, art-naïve, hiv rna viral load, race, art-naive, Infectious Diseases, Immunology, HIV-1, RNA, Viral, Female, Sample collection, business, Viral load
Abstract

Objective: To assess pregnancy levels and patterns of HIV RNA in the absence of antiretroviral therapy, while appropriately adjusting for potential confounders, including maternal immune status and race. Methods: Data on >= 1 antenatal HIV RNA measurements were available for 333 untreated HIV-infected pregnant women enrolled in the European Collaborative Study. CD4 counts and HIV RNA measurements were routinely collected from 1992 and 1998, respectively. Linear mixed effects models based on 246 women for whom complete data were available examined changes in HIV RNA levels over pregnancy, with a nested random effects term accounting for measurement variability within women and period of sample collection. Results: The change in HIV RNA over pregnancy varied significantly by race (p = 0.005): from the second trimester until delivery, HIV RNA decreased significantly by an estimated 0.019 log(10) copies/ml/week in white women (95% Cl -0.03, -0.007); in black women the estimated 0.016 log(10) copies/ml/week increase (95% Cl -0.005, 0.037) was not statistically significant. At delivery, HIV RNA levels in black women were 0.45 log(10) copies/ml higher (95% Cl 0.08, 0.83) than in white women. Conclusions: Our findings suggest that HIV RNA dynamics over pregnancy differ by race, although other interpretations cannot be excluded, due to potential for unmeasured confounding. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved

Full Text
View/download PDF

18. The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West

Author

Giaquinto, C., Rampon, O., D Elia, R., Anita De Rossi, Grosch-Woerner, I., Feiterna-Sperling, C., Schmitz, T., Casteleyn, S., Mok, J., Jose, I., Bates, I., Larru, B., Pena, J. M., Garcia, J. Gonzalez, Lopez, J. R. Arribas, Garcia-Rodriguez, M. C., Asensi-Botet, F., Otero, M. C., Perez-Tamarit, D., Suarez, G., Scherpbier, H., Kreyenbroek, M., Godfried, M. H., Nellen, F. J., Boer, K., Bohlin, A. B., Lindgren, S., Belfrage, E., Naver, L., Anzen, B., Lidman, K., Levy, J., Hainaut, M., Goetghebuer, T., Manigart, Y., Barlow, P., Ferrazin, A., Bassetti, D., Maria, A., Bentivoglio, G., Ferrero, S., Gotta, C., Mur, A., Paya, A., Lopez-Vilchez, M. A., Carreras, R., Valerius, N. H., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguna, J., Caro, M. Casellas, Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., Santis, M., Savasi, V., Ferrazzi, E., Vigano, A., Giacomet, V., Probizer, F. Ravagni, Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Niemiec, T., Marczynska, M., Oldakowska, A., Kaflik, M., Posokhova, S., Kaleeva, T., Stelmah, A., Kiseleva, G., and European Collaborative, Study

19. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy

Author

Giaquinto, C., Ruga, E., Anita De Rossi, Grosch-Worner, I., Mok, J., Jose, I., Bates, I., Hawkins, F., Guevara, C. L., Pena, J. M., Garcia, J. G., Lopez, J. R. A., Garcia-Rodriguez, M. C., Asensi-Botet, F., Otero, M. C., Perez-Tamarit, D. P., Suarez, G., Scherpbier, H., Kreyenbroek, M., Boer, K., Bohlin, A. B., Lindgren, S., Ehrnst, A., Belfrage, E., Naver, L., Lidman, K., Anzen, B., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., Bassetti, D., Maria, A., Gotta, C., Mur, A., Paya, A., Vinolas, M., Lopez-Vilchez, M. A., Rovira, Carreras, R., Valerius, N. H., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Caro, M. C., Canet, Y., Savasi, V., Vigano, A., Ferrazi, E., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Agangi, A., Sansone, M., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Niemiec, T., Marczynska, M., Horban, A., and European Collaborative, Study

20. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

European Collaborative Study, Newell, Ml, Giaquinto, C., Ruga, E., Rossi, A., Grosch-Worner, I., Mok, J., Johnstone, F., Jose, I., Bates, I., Salas, S., Guevara, Cl, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia-Rodriguez, Mc, Asensi-Botet, F., Otero, Mc, Perez-Tamarit, D., Ridaura, S., Gregori, P., La Torre, R., Scherpbier, H., Kreyenbroek, M., Boer, K., Bohlin, Ab, Lindgren, S., Ehrnst, A., Belfrage, E., Lars Naver, Levy, J., Barlow, P., Hainaut, M., Peltier, A., Wibaut, S., Ferrazin, A., Bassetti, D., Maria, A., Gotta, C., Mur, A., Paya, A., Vinolas, M., Lopez-Vilchez, Ma, Rovira, Ma, Carreras, R., Valerius, Nh, Coll, O., Vidal, R., Perez, Jm, Boguna, J., Fortuny, C., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Savasi, V., Vigano, A., Ferrazzi, E., Brambilla, T., Bianchi, L., Maccabruni, A., Taylor, Gp, Lyall, Egh, Penn, Z., Buffolano, W., Martinelli, P., Sansone, M., Tibaldi, C., Marini, C., Masuelli, G., Benedetto, C., Niemiec, T., and Marczynska, M.

22. Simultaneous intrapartum uterine and bladder rupture.

Author

Oteng-Ntim E, Iskaros J, Dinneen M, and Penn Z

Subjects
Adult, Female, Humans, Pregnancy, Rupture, Spontaneous, Urinary Bladder Diseases pathology, Urinary Bladder Diseases surgery, Uterine Rupture pathology, Uterine Rupture surgery, Obstetric Labor Complications, Urinary Bladder Diseases etiology, Uterine Rupture etiology, Vaginal Birth after Cesarean adverse effects
Published
2002
Full Text
View/download PDF

24. Elective or selective caesarean delivery of the small baby? A systematic review of the controlled trials.

Author

Grant A, Penn ZJ, and Steer PJ

Subjects
Anesthesia, Obstetrical, Apgar Score, Breech Presentation, Elective Surgical Procedures, Female, Humans, Pregnancy, Randomized Controlled Trials as Topic, Cesarean Section adverse effects, Cesarean Section statistics & numerical data, Obstetric Labor, Premature surgery
Abstract

Objective: To compare a policy of elective caesarean delivery with a policy of selective caesarean delivery for women in spontaneous preterm labour., Design: Systematic review of relevant randomised controlled trials., Participants: One hundred and twenty-two women from six trials., Interventions: Random allocation to "intention to deliver by caesarean section' (elective caesarean policy), compared with "intention to deliver vaginally' (selective caesarean policy)., Main Outcome Measures: Actual use of caesarean delivery, low Apgar score, neonatal intubation, intracranial pathology, perinatal death, and major maternal complications., Results: One in six women in both groups were not delivered as allocated. Typical odds ratios for all adverse neonatal outcomes tended to favour the elective group, but for all outcomes studied the confidence intervals were wide and did not exclude clinically important hazards of the policy. The odds of serious maternal morbidity were increased in the caesarean section group (OR 6.2; 95% CI 1.3-30.1)., Conclusion: A policy of elective caesarean delivery increases the risks of maternal morbidity, but it remains unclear whether these are offset by benefits for the infant.

Published
1996
Full Text
View/download PDF

25. A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant.

Author

Penn ZJ, Steer PJ, and Grant A

Subjects
Adult, Elective Surgical Procedures, Female, Humans, Infant Mortality, Infant, Newborn, Pregnancy, Pregnancy Outcome, Breech Presentation, Cesarean Section, Obstetric Labor, Premature
Abstract

Objective: To determine the optimum mode of delivery for women in preterm breech labour at a gestational age of 26 to 32 weeks., Design: A multicentre randomised controlled trial., Setting: Twenty-six hospitals in England, UK., Participants: Women with a singleton breech fetus in spontaneous preterm labour between 26 and 32 completed weeks of gestation, with no clear indication for a caesarean section or vaginal breech delivery., Intervention: Random allocation to either "intention to delivery vaginally' or "intention to deliver by caesarean section'., Main Outcome Measures: Perinatal mortality, neonatal morbidity, maternal morbidity and gestation at delivery., Results: The trial was closed after 17 months because of low recruitment, by which time substantial numbers of women had been in the eligible gestation period. Thirteen women from six hospitals were recruited. One infant, randomised to and delivered vaginally, was stillborn. Three fetal presentations were cephalic at delivery despite a diagnosis of breech presentation at trial entry. No formal statistical analysis was performed due to the small numbers., Conclusions: No conclusions about the optimum mode of delivery for women in preterm labour with a fetus presenting by the breech can be drawn from this trial. The low accrual rate was due to clinicians' reluctance to randomise eligible women, reflecting the circumstances and nature of the trial.

Published
1996
Full Text
View/download PDF

27. How obstetricians manage the problem of preterm delivery with special reference to the preterm breech.

Author

Penn ZJ and Steer PJ

Subjects
England, Female, Fetal Monitoring statistics & numerical data, Gestational Age, Humans, Pregnancy, Surveys and Questionnaires, Wales, Breech Presentation, Cesarean Section statistics & numerical data, Obstetric Labor, Premature therapy
Abstract

A questionnaire regarding the route of birth for the preterm fetus with particular reference to the management of the preterm breech was sent to 180 consultants in England and Wales. Only 23% of respondents use electronic fetal monitoring below 26 weeks gestation and only 12% use caesarean section routinely for fetal indications at less than 26 weeks. Only 12% will use caesarean section for the preterm fetus presenting by the vertex in uncomplicated labour. Only 35% of all respondents consider that there is sufficient evidence to support the use of caesarean section for the uncomplicated preterm breech, but 76% will actually use caesarean section for this indication. Overall 71% reported that they are affected by medicolegal considerations in their management of the preterm breech. Overall, 83% said that they might change their practice regarding the mode of delivery of the preterm breech in the light of the findings of a randomized prospective controlled trial.

Published
1991
Full Text
View/download PDF

28. Reasons for declining participation in a prospective randomized trial to determine the optimum mode of delivery of the preterm breech.

Author

Penn ZJ and Steer PJ

Subjects
Cesarean Section, Feasibility Studies, Female, Humans, Infant, Newborn, Informed Consent, Pregnancy, Prospective Studies, United Kingdom, Breech Presentation, Delivery, Obstetric, Infant, Premature, Randomized Controlled Trials as Topic methods
Abstract

Increasing numbers of preterm breech infants are being delivered by cesarean section, which confers no proven advantage to the infant and subjects the mother to increased risk. In order to assess the feasibility of performing a randomized controlled trial to compare elective with selective cesarean delivery for the preterm breech infant, consultants in 36 hospitals were asked if they would be willing to participate. In 25 hospitals all consultants agreed to participate, whereas in 11 universal support was not obtained. The reasons given for nonparticipation included the potentially time-consuming nature of the consent procedure, which it was proposed should be undertaken with all women during the antenatal period, concern that a large proportion of non-English speak women would not be able to give truly informed consent, anxiety about the seniority, availability, and requisite skill of the personnel delivering the preterm breech, doubts about the details of the protocol, medicolegal considerations, and disagreement about the desirability of the trial among the consultant members of a department. If prospective evaluation of clinical practice is to be carried out in the future the staffing levels of obstetric departments must taken into account the additional work load that this entails.

Published
1990
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results