Excess Intrauterine Fetal Demise Associated with Maternal Human Immunodeficiency Virus Infection

• Published in: The Journal of infectious diseases Vol. 172; no. 6; pp. 1451 - 1460
• Main Authors: Langston, Claire, Lewis, Dorothy E., Hammill, Hunter A., Popek, Edwina J., Kozinetz, Claudia A., Kline, Mark W., Hanson, I. Celine, Shearer, William T.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-12-1995; University of Chicago Press
• Subjects: Adolescent; Adult; AIDS; AIDS/HIV; Biological and medical sciences; Child; Disease transmission; Female; Fetal Death - etiology; Fetus; HIV; HIV Infections - complications; human immunodeficiency virus; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; In situ hybridization; Infections; Infectious Disease Transmission, Vertical; Major Articles; Medical sciences; Placenta; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Twins; Women; Human; Immunopathology; Pregnancy disorders; AIDS; Immune deficiency; Infection; Pregnancy; Pathology; Habitual abortion; Viral disease; Female; Fetus; Frequency
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/172.6.1451

A prospective study of transplacental transmission of human immunodeficiency virus (HIV) showed an increased rate of spontaneous fetal demise in HIV-seropositive mothers: 14 losses in 124 pregnancies. HIV was detected in placental and fetal tissues in 7 of 14 by in situ hybridization. The proportion of fetal infection far exceeded the transmission rate of 13% in liveborn babies. No association was seen between fetal transmission and a maternal history of drug abuse or coinfections; mothers with AIDS more often had fetal loss associated with HIV transmission than did asymptomatic mothers. In affected fetuses, HIV was detected in many tissues and was associated with thymic pathology. This suggests that maternal HIV infection increases the risk for pregnancy loss associated with HIV transmission. The possibility that HIV may be fetotoxic, that thymic dysfunction may interfere with pregnancy progression, or that the intrauterine milieu in HIV-seropositive pregnancies may be unfavorable (or a combination of factors) should be considered.