JAMA : the journal of the American Medical Association
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The Centers for Disease Control and the American College of Obstetricians and Gynecologists have recommended that pregnant women who are at increased risk for acquired immunodeficiency syndrome be tested for antibodies to human immunodeficiency virus. When this recommendation is implemented, some clinicians who undoubtedly have had limited experience with patients infected with human immunodeficiency virus will be responsible for the care of pregnant women found to be asymptomatically infected with human immunodeficiency virus. There is, therefore, a need for information that will ensure that adequate counseling is provided and that appropriate medical and infection control measures are instituted. This article will review issues related to counseling and antepartum, intrapartum, and postpartum care of seropositive pregnant women.
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Although perinatal transmission of the human immunodeficiency virus (HIV) is well documented, seroprevalence rates of HIV in populations of women of reproductive age have not yet been reported. To determine the seroprevalence of HIV in childbearing women from a population with a high incidence of acquired immunodeficiency syndrome, cord blood samples were collected from 602 infants delivered at an inner-city municipal hospital in New York. Demographic and HIV risk factor information was also collected from mothers of these infants. ⋯ This serosurvey indicates that HIV infection of inner-city parturients is a significant problem that warrants broadly implemented health strategies. Furthermore, the data also suggest that if risk factor information elicited by physicians is used to initiate HIV antibody counseling and testing of pregnant women, a significant number of seropositive parturients is missed. In areas with significant seroprevalence rates of HIV infection, a broader counseling and testing program may be needed.