Recommendations for assisting in the prevention of perinatal transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus and acquired immunodeficiency syndrome.

The majority of cases of pediatric acquired immunodeficiency syndrome (AIDS) are transmitted perinatally. 165 (76%) of the cases of AIDS in children under 13 years of age reported as of December 1, 1985, in the US had as the only known risk factor a mother from a high-risk group. However, perinatal transmission from an infected mother to her infant is not automatic; studies have placed the rate of transmission from 0%-65%. A concern in addition to the risk posed to infants born to infected mothers is evidence of an increased likelihood of developing full-blown AIDS when infection with the AIDS virus occurs in association in pregnancy. Target groups for counseling and testing for antibodies to the AIDS virus should include pregnant women or those who may become pregnant who already have evidence of AIDS infection, are intravenous drug abusers, were born in countries where there is a high rate of heterosexual transmission of AIDS, are prostitutes, or are the sexual partners of men in high-risk groups. Such counseling and testing should be made available through the settings that women at increased risk frequent, including drug abuse treatment programs and sexually transmitted diseases clinics. Infected women should be advised to delay pregnancy until more is known about the perinatal transmission of AIDS. Pregnancy infected women should be closely monitored for the development of opportunistic infections as well as psychosocial difficulties. Although these recommendations pertain to women, men who are infected with the AIDS virus also should be counseled about risks of perinatal transmission.