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Human Immunodeficiency Virus (HIV) and Pregnancy

Reviewed by James Brann, M.D.

Pregnancy and HIV

Learn about HIV and pregnancy.

It is estimated that about 2 out of every 1,000 pregnant women are infected with HIV (human immunodeficiency virus). This virus is spread through contact with an infected person’s bodily fluids, such as blood and semen, but in rare cases, it can be spread through blood transfusions. Infected mothers can pass the virus to their baby during the pregnancy, during birth, and, to a lesser degree, through breastfeeding. Fortunately, the treatments of HIV during pregnancy and birth can dramatically reduce the risk of passing HIV to your infant. This is why it is strongly recommend that all pregnant women undergo screening for HIV infection.

In many cases, a person with HIV does not immediately get sick. It may take five years or more before symptoms appear. These can include flu-like symptoms, unexplained weight loss, fatigue, swollen lymph nodes, cold sweats, fever, diarrhea, and cough.

Although this is a life-long illness that has no cure, there are steps that you can take to stay healthy and to protect your baby from becoming infected.

Treating HIV during Pregnancy

Treating a mother with HIV greatly reduces the infection rate of the baby. If a pregnant women with HIV starts treatment during weeks 14 to 34 of her pregnancy, her baby has less than an 8 percent chance of getting infected, or 1 in 12. If she does not get treated, about 25 percent of the babies (1 in 4) will get the virus.

Your risk of passing the virus to your baby depends on your viral load—or how much of the virus you have in your blood.

For best outcomes, if you are HIV positive, you should continue to take your medication during pregnancy, labor, and delivery.

Like with other diseases, medications that are used to treat HIV can affect your baby’s health. Stopping treatment will increase your baby’s risk of infection.

Many babies who end up with HIV are usually infected around the time of delivery. During the labor and delivery process, the baby can be exposed to the mother’s body fluids, i.e. the amniotic sac, which can spread the virus. If an infected woman’s water breaks, her baby is at higher risk of infection. Because of this, many pregnant women with HIV are offered cesarean sections before their due date.

Although having a c-section may be more beneficial to the baby, mothers with weaker immune systems have a higher chance of getting infections. Drugs to prevent infection may be given to these women when they deliver.

After your baby is born, he or she will be tested for HIV. Even if a baby tests positive at birth, this does not necessarily mean that your baby is HIV positive. Many babies that are not infected but test positive may still have the mother’s antibodies in his or her blood. By 6 months, these antibodies disappear.

To decrease your baby’s chance of becoming infected, babies of HIV-positive moms are treated with medication within 12 hours after delivery.

If you are HIV positive, you should not breast feed your child.

Breast milk can pass on the virus. Infant formula is the safest way to provide your baby with the nutrients he or she needs. Because you are not breastfeeding, your breasts may become full of milk (engorged) and may hurt for several days after delivery. To relieve the pain, support your breasts in a tight bra or bind them with an elastic bandage. Apply ice and take over-the-counter pain relievers, like acetaminophen or ibuprofen. Do not apply heat or massage to your breasts, as this will increase the milk production.

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