Postpartum Morbidity Associated With Advanced HIV Disease

OBJECTIVE To investigate the postpartum morbidity and postpartum management of febrile morbidity associated with advanced HIV infection. METHODS A case control study of HIV infected women at a tertiary care center during January 2000-June 2005 was performed. Postpartum morbidity was defined as endometritis, blood transfusion, wound complication, readmission, infectious morbidity, or unexpected surgery. RESULTS Women in Group 1 had AIDS (N=33), Group 2 were relatively immunocompetent HIV infected women (N=115), and Group 3 were uninfected women (N=152). Group 1 was more likely to have a postpartum morbidity (32.3 versus 19.3 and 13.2%, P=.03) and to have postpartum imaging 18.8 versus 7.9 and 2.6%, P=.002. After controlling for potential confounders, cesarean delivery (OR 6.2, 95% CI 2.1-505.5) but not advanced HIV disease was associated with an increased risk of postpartum morbidity. CONCLUSION Cesarean delivery and not advanced HIV disease increases the risk of postpartum morbidity in women with AIDS.