Association between HIV infection status and infectious complications after an elective c-section

Abstract

Objectives: To determine the connection between HIV and infectious complications (IC) after an elective C-section. Materials and methods. A non-concurrent cohort study was conducted, in which the clinical records of 237 elective C-sections on HIV-positive pregnant women who gave birth at the Instituto Nacional Materno Perinatal (National Maternal Perinatal Institute) between 2004 and 2012 were revised. The records were matched by surgeon and C-section date, with 237 HIV-negative pregnant women. Socio-demographic and clinical data were collected, along with characteristics of the C-section and data related to the HIV infection. IC were evaluated according to the NIH Consensus Development Task Force. The descriptive analysis and the bivariate analysis were carried out with a significance level of 5% for the hypothesis tests and the calculation of the Odds Ratio (OR) with a confidence interval (CI) at 95%. A conditional logistic regression model was built. Results. IC were present in 13.9% of HIV-positive women and 9.7% of the control group (OR: 1.5 CI95% [0.9-2.7]); those who were exposed (women with HIV) were more likely to have a urinary tract infection (UTI) than those who were not exposed (ORa: 4.5 CI95% [1.4-14.5]). A connection was found between the IC and the type of incision (ORa: 2.3 CI95% [1.1-4.5]) and time of hospitalization (6 versus 3 days, p<0.001). Conclusions. Exposed women did not register a greater global risk of IC after an elective C-section; however, they were, indeed, more likely to get a UTI. Those HIV-positive women who were not receiving antiretroviral treatment were in greater risk of IC. The main risk factors associated with a post C-section IC in HIV-positive women were the type of incision, as well as the surgery time with the UTI.