Maternal and neonatal risk factors associated with increased mother-to-child transmission of HIV-1 in Mexico: Results of a case–control study

Abstract

Background Maternal, obstetric and neonatal factors that increase the possibility of mother-to-child HIV transmission (MTCT) are known as mechanisms of transmission. Our aim was to determine the risk factors associated with MTCT in Mexico. Methods We conducted a case–control study from March to December 2015. Cases were 60 mothers with HIV infection who transmitted HIV to their children, and controls were 120 mothers with HIV infection whose children tested negative for HIV. Data were extracted from medical records and a self-reported questionnaire for each participant. To determine associations with MTCT, odds ratios (ORs) and 95% confidence intervals (CI) were obtained with the chi-squared test and a logistic-regression modeling. Results A total of 180 patients were included. HIV diagnosis for cases occurred after pregnancy in 88% of the patients, during pregnancy in 9%, and before pregnancy in 3% of patients. Among the controls, 38% of patients were diagnosed before pregnancy, 32% during pregnancy, and 30% after pregnancy. In multivariate analysis, the risk factors associated with MTCT were: absence of antiretroviral treatment during pregnancy (OR 5.21; 95% CI 1.24–16.11; p = 0.019); vaginal delivery (OR 3.2; 95% CI 1.27–8.26; p = 0.014); forceps-assisted delivery (OR 13.4; 95% CI 1.91–93.66; p = 0.009); breastfeeding (OR 6.23; 95% CI 2.27–17.05; p = <0.001) and the practice of mixed breastfeeding (OR 4.6; 95% CI 1.56–13.73; p = 0.006). Conclusions MTCT is preventable with early diagnosis; treatment initiation before pregnancy and avoidance breastfeeding could decrease the risk of transmitting HIV to their children.