Perioperative cesarean delivery morbidity among HIV-infected women under highly active antiretroviral treatment: a case-control study.

OBJECTIVE: To compare post-cesarean complications between HIV-infected women on highly active antiretroviral therapy (HAART) and a matched group of non-HIV-infected women, and to evaluate predisposing risk factors for these complications in the HIV group. STUDY
DESIGN: We performed a retrospective study of 160 HIV-infected women and 320 non-infected women who underwent cesarean section in a single reference center from 1997 to 2007. All HIV patients were under high active antiretroviral therapy (HAART). The women were assessed for a large number of major and minor postoperative complications. Selected risk factors for perioperative morbidity were analyzed in the HIV-positive group and data were analyzed using logistic regression. RESULT(S): Overall postoperative complications did not differ significantly between the two groups (26.9% in HIV patients vs. 22.8% in controls; OR = 1.24; 95% confidence interval [CI] = 0.8-1.92). Anemia was the most frequent morbidity observed, affecting 17.5% of HIV-positive women and 11.8% of controls. Major complications were associated with a CD4+ cell count of < 500 cell/ml (OR = 3.28, 95% CI = 1.04-10.31) and prematurity < 34 weeks (OR = 9.76, 95% CI = 1.99-47.71). CONCLUSION(S): Post-cesarean complications were not significantly increased in HIV-infected women on HAART compared to non-HIV-infected women. Prematurity and low CD4+ cell count were risk factors for major complications.