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HIV AIDS & Pregnancy
If you're pregnant and have just discovered that you
are HIV positive don't panic, because with medical help and advice
the risk of your baby being HIV positive can be as low as 2%. With
no medical help the risk of your baby being infected with HIV is
between 20 - 45%.
HIV can be transmitted from mother to baby
(mother-to-child/vertical transmission):
• during pregnancy
• during birth
• after birth, through breastfeeding
The most important things you can do to prevent your
baby becoming HIV positive are:
• taking antiretroviral drugs during labour
• giving the baby a short course of antiretroviral
drugs after birth
This will reduce the risk of your baby being HIV
positive by nearly 50%.
Depending on which country you live in other things
you may be able to do are:
• take antiretroviral drugs during your pregnancy
• have a caesarean delivery
• not breastfeed
This will reduce the risk to around 2%.
There are different drug treatment regimens
available to prevent your baby becoming HIV positive that you can
take during pregnancy and delivery. The most important time for the
mother to take antiretroviral drugs is during labour, and for the
baby immediately after it is born.
The most effective regimen for preventing
transmission of HIV from mother to baby (available in high-income
countries) is taking AZT from 14 to 34 weeks of pregnancy to birth,
intravenous AZT during labour and AZT for the baby for six weeks.
Without breastfeeding, this can reduce the rate of transmission to
around 2%.
Other effective drug regimens include:
• AZT from 28 weeks of pregnancy, during labour and
for 1 week for the baby.
• AZT and 3TC from 36 weeks, of the pregnancy,
during labour and for 1 week for mother and baby after birth.
If you don't have access to drugs during pregnancy
and before your delivery, taking a single dose of nevirapine during
labour and giving the baby a single dose of nevirapine at birth will
reduce the risk of around of transmission to around 10 - 20% without
breastfeeding.
If they are available, you can also take drugs
earlier during your pregnancy. Whether you take them depends on how
far along in your pregnancy you are and how ill you are with HIV.
Sometimes an HIV positive woman who is already on
treatment will find out that she is pregnant. Advice should be
obtained urgently from your doctor about what is best for you to do.
It may be sensible for you to change the drugs that you are taking,
as some drugs are more suitable during pregnancy than others. It is
not a good idea to come off or change your therapy before seeing
your doctor. If you stop treatment suddenly during pregnancy, your
viral load may rebound, and there may be an increased risk of HIV
transmission to the baby. If you are thinking of changing or
stopping treatment, you must see your doctor.
Probably. Some studies have shown evidence of an
increased risk of a baby being premature or low birth weight due to
the use of HIV drugs during pregnancy, particularly protease
inhibitors. However this is controversial and there have been
studies showing no evidence of this.
A caesarean section is an operation used to deliver
a baby through its mother's abdominal wall. When a mother is HIV
positive it is done to protect the baby from direct contact with her
blood and other bodily fluids.
Recent research shows that having a caesarean isn't
a significant factor in preventing the transmission of HIV from
mother to baby. So unless you are ill with HIV or have a detectable
viral load it probably won't be recommended by your health care
provider. Having a caesarean section delivery may also not be
possible in many countries.
HIV is found in breast milk. If you do breastfeed
there is a 25-45% chance of passing HIV to your baby. Not
breastfeeding lowers this to 15-25%. So, if you have access to safe
breast milk substitutes (formula) you are advised to not breastfeed.
If you live in a country where safe water isn't
available, the risk of life-threatening conditions from formula
feeding may be higher than the risk from breastfeeding. Formula can
also be too expensive to use regularly in some countries. If you are
this situation it is better to feed your baby breast milk alone.
Mixed feeding is when a baby is fed with breast milk
and other liquids such as formula, glucose water, gripe water or
traditional medicine. It is now known that there is a higher risk of
a baby becoming HIV positive from mixed feeding than exclusive
formula feeding alone or breastfeeding. Mixed feeding may damage the
lining of the baby's |
