Twin Pregnancy Raises Risk of HIV Spread
June 19, 2007
HIV-infected pregnant women are more likely to transmit the virus to their babies if they are carrying twins, according to a study by Dr. Laurent Mandelbrot of the University of Paris and colleagues.
Prior to the advent of highly active antiretroviral therapy (HAART) in 1997, the mother-to-child HIV transmission rate in twin pregnancies was two to three times that in singleton pregnancies. Since HAART, rates for the two groups have been similarly low.
After adjusting the pre-HAART data for length of pregnancy, delivery method and other factors, the researchers found that twin pregnancy remained associated with a 2.3-fold increased risk of mother-to-child HIV transmission. The association was especially strong, they noted, in cases of premature rupture of the membranes around the fetus. In these cases, the transmission risk increased 4.5-fold.
"In cases of multiple pregnancies in HIV-infected women, [physicians] must take into account the risk of preterm premature rupture of the membranes and preterm delivery," concluded the researchers. "In particular, we would recommend starting effective [anti-HIV] therapy no later than beginning of the second trimester."
The study, "Twin Pregnancy as a Risk Factor for Mother-to-Child Transmission of HIV-1: Trends Over 20 Years," was published in AIDS (2007;21(8):993-1002).
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.