Abstract

2/3 of the reported cases of the acquired immune deficiency syndrome (AIDS) in children have no risk factor except a mother belonging to a group with an increased prevalence of infection with human immunodeficiency virus (HIV). There is evidence of transplacental passage of the virus during early and late gestation, but the incidence of fetal and neonatal infection in newborn babies of seropositive mothers has not yet been determined. This article presents the clinical and serological outcome of 24 babies aged 6 months born to mothers who were drug addicts and positive for HIV antibodies. At 6 months 12 babies were seropositive and 12 seronegative. 1 seropositive baby died of Pneumocystis carinii pneumonia at 4 months, and another was diagnosed as suffering from AIDS related complex at the age of 3 months. All the other babies thrived, the results of their follow up being entirely normal. These 2 cases indicate that early morbidity and mortality are a severe problem, but their incidence seems to be restricted to about 10% of the offspring. Unfortunately, nothing can yet be said about long term morbidity and mortality. Cesarean section does not seem to protect the fetus from infection. These data may be helpful in counselling seropositive women before or in early gestation, as they suggest that the risk of fetal infection and severe postnatal morbidity is high. Unfavorable perinatal outcome, usually associated with drug addiction, was similar in seropositive and seronegative women: a detrimental effect of the virus in this regard was not evident.

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