The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1--a meta-analysis of 15 prospective cohort studies. The International Perinatal HIV Group.

Warren A Andiman, Mattieu Boucher,David N Burns,Yvonne J Bryson, John P Farley, H G Fowler, C Gabiano,Luisa Galli,Cecelia Hutto, C Kind,Bette T Korber,Andrea Kovacs,Paul Krogstad,Sheldon Landesman,Nichole E Lapointe, Mireille Lemay,Judy Lew,Laurent Mandelbrot,M J Mayaux,Robert B Mellins,H Minkoff,Lynne M Mofenson,Karin Nielsen,M L Newell,Giorgio Pardi,Hannah Peavy,C S Peckham,Jennifer S Read,C Rother,C Rudin,Gwendolyn B Scott,A E Semprini,William T Shearer,R J Simonds,B Simpson,Alice Stek,P A Tovo,Ruth Tuomala, R Van Dyke, Jeremy Weedon,M De Martino,M Lindsay, S Belair,L Chan, David M Harris,Leslie A Kalish,Larry R Muenz,Robert P Nugent,Mark D Schluchter,Stephen J Durako, Scott H Goodwin, Richard M Mitchell,Parivash Nourjah,William F Owen,Susan M Widmayer,Arlene Bardeguez,Celine Hanson,Andrew A Wiznia,Katherine Luzuriaga,R R Viscarello,David Ho,Richard A Koup, Ichieh Chen,James I Mullins,Steven M Wolinsky,Bruce D Walker,Arthur J Ammann,Sheila Clapp, Daniel Mcdonald,M Fauvel, Catherine Hankins,Johanne Samson, Anthony J Bailey,Carlo Giaquinto, E M Ruga,A De Rossi,D Truscia, I Groschworner, Andrew I Schafer,J Mok, F D Johnstone, J Jiminez, C De Alba, M Garciarodriguez,I Bates, I De Jose, F Hawkins, R M Zapico, F Asensibotet, M C Otero, D Pereztamarit,A Moya,M J Galbis,H Scherpbier, K Boer,A B Bohlin, Stefan Lindgren, A Ehrnst, B Anzen, E Belfrage, Joseph M Levy,A Alimenti, Peter G Barlow, A Ferrazin,A De Maria, C Gotta, Maritati,A Mur, M Rovira,A Paya,O Coll, Claudia Fortuny, J Boguna, M C Caro, Y Canet, M Ravizza, C Castagna, Simona Fiore,Brunella Guerra,Marcello Lanari, S Bianchi,Luciano Bovicelli, E Prati,M Duse,Annarosa Soresina,G Scaravelli,M De Santis,M L Muggiasca,Alessandra Vigano,Pier Carlo Marchisio,Angela Iasci,Arsenio Spinillo, A Bucceri,Enzo Grossi, L Rancilio, M Della Torre,P Dallacasa, A Pachi,Nicola Principi,Carlo Zara, Matteo Centis Vignali,Gian Paolo Rossi,L Selvaggi, P Greco,Antonella Vimercati, G B Massi, T A Innocenti, A Fiscella, Matilde Sansone,Chiara Benedetto, Carmelo Tibaldi,Nahid Ziarati, B Tadrist, D Thevenicau, J Gondry, B Paulard, C Alisy,D Brault, P Tordjeman, J Mamou,M A Rozan, D Colombani, O Pincemaille,Antonio Salvetti, C Chabanier, X Hernandorena, J L Leroy, J P Schaal, P Balde, Ph Faucher, E Lachassinne, Stephen E Benoit, D Douard,C Hocke, P Barjot,Jacques Brouard, P Delattre, L Stien,Francois Audibert,Philippe Labrune, M Vial,Fabienne Mazy, D Sitbon,Catherine Crennhebert,Corinne Flochtudal, R Akakpo, C Daveau, Anne Leblanc, P Cesbron, H Duvalarnould, C Hurauxrendu, S Lemerle, Claudine Touboul, M Guerin, C Maingueneau, I Reynaud, T Rousseau, Ercoil,Marilyn L Lanza,M F Denavit,Jane Luce Garnier, K Lahsinat, R Pia, Claude Allouche,M Nardou, Franck Grall,A May, M Dallot, P E Lhuillier,W Cecile, Raymond Mezin,A Bech, J B Lobut, G Algava, A C Dermesay,Ronald W Busuttil, M Jacquemot, B Badermeunier,S Fridman, X Codaccioni, F Maxingue,David L Thomas,J Alain,L De Lumley, J L Tabaste, P B Salin, H Seaume, A Guichard,Kamila Kebaili, C Roussouly, C Botto,A De Lanete,Pierrejean Wipff, L Cravello, P De Boisse, M Leclaire,G Michel, C Crumiere, Lefevre,B Le Lorier, I Pauly,B Robichez, D Seguy, M Dehlinger, F Rideau, P Talon,Panayiotis V Benos, C Huret, J L Nicolas, Brigitte Hellerroussin, S Saintleger, Maryse Delaporte,C Hubert, B De Sarcus, P Karoubi, F Mechinaud, D Bertcrottiere, A Bongain, F Monpoux,C De Gennes, F Devianne,I Nisand,M Rousset,Genevieve Mouchnino,J M Muray, Martine Munzer,C Quereux, Brossard, Brigitte Clavier, M C Allemon, D Rotten,Jean Louis Stephan, M Varlet, Bernard Guyot, P Narey, F Bardinet, F De Caunes,R Jeny, Mark L Robin, A R Bouley, L Savey,Albert S Berrebi, J Tricoire, J C Borderon,A Fignon, Francois L Guillot,B Maria, A Broyard, Y Chitrit,Ghislaine Firtion, M L Pillet, S Parat, C Boissinot, N Garec,M J Levine, A Ottenwalter,F Schaller, B Vilmer, C Courpotin,C Brunner,Nicole Ciraruvigneron, G Hatemgantzer,Xavier Fritel, A Wallet, J Bouille,J Milliez,D B Mrejen, E Dermer, G Noseda, D Bardou, J Cressaty,C Francoual,C Carlus Moncomble,Harris L Cohen,Stephane Blanche, H Bastion, Jl Benifla, F Benkhatar, Nadia Berkane,F Herve, M Ronzier,G Ferraris, L Rancillo,S Tulisso,Carlo Scolfaro, Caterina Riva,Alberto Vierucci,M De Luca, Silvia Farina,C Fundaro,Orazio Genovese, G Mercu,Gian Luca Forni,M Stegagno,P Falconieri

The New England journal of medicine（1999）

引用 598|浏览72

暂无评分

摘要

To evaluate the relation between elective cesarean section and vertical transmission of human immunodeficiency virus type 1 (HIV-1), we performed a meta-analysis using data on individual patients from 15 prospective cohort studies.North American and European studies of at least 100 mother-child pairs were included in the meta-analysis. Uniform definitions of modes of delivery were used. Elective cesarean sections were defined as those performed before onset of labor and rupture of membranes. Multivariate logistic-regression analysis was used to adjust for other factors known to be associated with vertical transmission.The primary analysis included data on 8533 mother-child pairs. After adjustment for receipt of antiretroviral therapy, maternal stage of disease, and infant birth weight, the likelihood of vertical transmission of HIV-1 was decreased by approximately 50 percent with elective cesarean section, as compared with other modes of delivery (adjusted odds ratio, 0.43; 95 percent confidence interval, 0.33 to 0.56). The results were similar when the study population was limited to those with rupture of membranes shortly before delivery. The likelihood of transmission was reduced by approximately 87 percent with both elective cesarean section and receipt of antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, as compared with other modes of delivery and the absence of therapy (adjusted odds ratio, 0.13; 95 percent confidence interval, 0.09 to 0.19). Among mother-child pairs receiving antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, rates of vertical transmission were 2.0 percent among the 196 mothers who underwent elective cesarean section and 7.3 percent among the 1255 mothers with other modes of delivery.The results of this meta-analysis suggest that elective cesarean section reduces the risk of transmission of HIV-1 from mother to child independently of the effects of treatment with zidovudine.

查看译文

关键词

meta analysis,cohort study

AI 理解论文

溯源树

样例

生成溯源树，研究论文发展脉络

Chat Paper

正在生成论文摘要