There are certain factors that increase the risk of MTCT of HIV. The most important risk factor is the amount of HIV in the mother's blood, known as the viral load. The risk of transmission to the infant is greatest when the mother's viral load is high; which is often the case with recent or advanced HIV infection, particularly if the woman is not on ARV medication. Some of the risk factors for transmission are the same, and some are different during pregnancy, labour and childbirth, and breastfeeding periods. These are:

a) During pregnancy: If the viral load is high (new infection and advanced diseases), poor immune status of the woman, having STI and malaria have strong evidence for MTCT of HIV; maternal poor nutrition, using substance (cigarette and alcohol during pregnancy), manipulation of the fetal position externally (external cephalic version) do have weak evidence for MTCT of HIV.

b) During labour and delivery: high viral load, prematurity, vaginal delivery, prolonged rupture of membrane (more than 4 hrs.), prolonged labour, the first infant in multiple births believed to have strong MTCT of HIV whereas suctioning the newborn's mouth and nose, episiotomy and artificial rupture of the membrane have weak evidence.

c) During breastfeeding: mixed feeding (breast and replacement), long duration of breastfeeding (longer than 12 months)and maternal, new HIV infection contribute strongly to MTCT of HIV. On the other hand, poor maternal nutrition, breast infection of the mother and oral disease of the infant have weak evidence on MTCT.

Last modified: Tuesday, 21 February 2017, 4:20 PM