Table 1.
Unadjusted and adjusted analysis of characteristics associated with a cesarean delivery compared to a vaginal delivery among HIV-infected women in the PACTG/IMPAACT cohort (N=6,444)
| Characteristic# | Total (N=6,444) n (%) |
Cesarean delivery (N=3,025) n (%) |
Vaginal delivery (N=3,419) n (%) |
Odds ratio, OR (95% CI) |
Adjusted odds ratio, AOR (95% CI) |
|
|---|---|---|---|---|---|---|
| Guideline period | 1998–1999 | 1,356 (21%) | 481 (16%) | 875 (26%) | Reference | Reference |
| 2000–2008 | 3,743 (58%) | 1,858 (61%) | 1,885 (55%) | 1.79 (1.58–2.04) | 1.62 (1.37–1.91)* | |
| 2009–2013 | 1,345 (21%) | 686 (23%) | 659 (19%) | 1.89 (1.62–2.21)* | 1.99 (1.62–2.43)* | |
| HAART period | Early (1998–2008) | 5,099 (79%) | 2,339 (77%) | 2,760 (81%) | Reference | |
| Late (2009–2013) | 1,345 (21%) | 686 (23%) | 659 (19%) | 1.23 (1.09–1.39)* | ||
| Study | PACTG 367 | 3,584 (56%) | 1,540 (51%) | 2,044 (60%) | Reference | |
| IMPAACT P1025 | 2,860 (44%) | 1,485 (49%) | 1,375 (40%) | 1.43 (1.30–1.58)* | ||
| Age at delivery (years) | <25 | 2,125 (33%) | 968 (32%) | 1,157 (34%) | Reference | Reference |
| 25–30 | 2,167 (34%) | 993 (33%) | 1,174 (34%) | 1.01 (0.90–1.14)* | 0.94 (0.81–1.09) | |
| >30 | 2,146 (33%) | 1,059 (35%) | 1,087 (32%) | 1.17 (1.03–1.31)* | 1.19 (1.02–1.38)* | |
| Unknown | 6 (0%) | 5 (0%) | 1 (0%) | |||
| Timing of HIV diagnosis | Prior to pregnancy | 4,315 (67%) | 2,072 (68%) | 2,243 (66%) | Reference | Reference |
| During pregnancy | 2,047 (32%) | 920 (30%) | 1,127 (33%) | 0.88 (0.80–0.98)* | 1.03 (0.89–1.19) | |
| Unknown | 82 (1%) | 33 (1%) | 49 (1%) | |||
| First trimester of prenatal care | First | 3,686 (57%) | 1,780 (59%) | 1,906 (56%) | Reference | |
| Second | 2,251 (35%) | 1,014 (34%) | 1,237 (36%) | 0.88 (0.79–0.98)* | ||
| Third | 483 (8%) | 222 (7%) | 261 (8%) | 0.91 (0.75–1.10) | ||
| Unknown | 24 (0%) | 9 (0%) | 15 (0%) | |||
| First trimester of ARV use | First | 2,742 (43%) | 1,328 (44%) | 1,414 (41%) | Reference | Reference |
| Second | 2,743 (43%) | 1,275 (42%) | 1,468 (43%) | 0.93 (0.83–1.03) | 0.95 (0.82–1.09) | |
| Third | 774 (12%) | 363 (12%) | 411 (12%) | 0.94 (0.80–1.10) | 0.88 (0.71–1.10) | |
| No ARV use | 185 (3%) | 59 (2%) | 126 (4%) | 0.50 (0.36–0.69)* | 0.32 (0.19–0.55)* | |
| Last ARV regimen before delivery | 3 or more ARVs with PI | 3,774 (59%) | 1,906 (63%) | 1,868 (55%) | Reference | |
| 3 or more ARVs with NNRTI | 886 (14%) | 381 (13%) | 505 (15%) | 0.74 (0.64–0.86)* | ||
| 3 or more NRTIs | 598 (9%) | 283 (9%) | 315 (9%) | 0.88 (0.74–1.05) | ||
| 2 NRTIs | 644 (10%) | 241 (8%) | 403 (12%) | 0.59 (0.49–0.70)* | ||
| Single NRTI only | 326 (5%) | 139 (5%) | 187 (5%) | 0.73 (0.58–0.92)* | ||
| None | 216 (3%) | 75 (2%) | 141 (4%) | 0.52 (0.39–0.70)* | ||
| First CD4 cell count in pregnancy (cells/mm3) | ≥500 | 2,317 (36%) | 1,067 (35%) | 1,250 (37%) | Reference | Reference |
| 350–<500 | 1,494 (23%) | 678 (22%) | 816 (24%) | 0.97 (0.85–1.11) | 0.94 (0.80–1.10) | |
| 200–<350 | 1,493 (23%) | 694 (23%) | 799 (23%) | 1.02 (0.89–1.16) | 0.94 (0.81–1.11) | |
| <200 | 905 (14%) | 492 (16%) | 413 (12%) | 1.40 (1.20–1.63)* | 1.13 (0.93–1.38) | |
| Unknown | 235 (4%) | 94 (3%) | 141 (4%) | |||
| Last CD4 cell count before delivery (cells/mm3) | ≥500 | 2,820 (44%) | 1,296 (43%) | 1,524 (44%) | Reference | |
| 350–<500 | 1,491 (23%) | 667 (22%) | 824 (24%) | 0.95 (0.84–1.08) | ||
| 200–<350 | 1,228 (19%) | 595 (20%) | 633 (19%) | 1.11 (0.97–1.26) | ||
| <200 | 670 (10%) | 373 (12%) | 297 (9%) | 1.48 (1.25–1.75)* | ||
| Unknown | 235 (4%) | 94 (3%) | 141 (4%) | |||
| First HIV viral load in pregnancy (copies/ml) | <500 | 2,269 (35%) | 1,039 (34%) | 1,230 (36%) | Reference | |
| 500–<1,000 | 349 (6%) | 156 (5%) | 193 (6%) | 0.96 (0.76–1.20) | ||
| 1,000–<10,000 | 1,679 (26%) | 762 (25%) | 917 (27%) | 0.98 (0.87–1.12) | ||
| ≥10,000 | 1,894 (29%) | 966 (32%) | 928 (27%) | 1.23 (1.09–1.39)* | ||
| Unknown | 253 (4%) | 102 (3%) | 151 (4%) | |||
| Last HIV viral load before delivery (copies/ml) | <500 | 4,495 (70%) | 1,958 (65%) | 2,537 (74%) | Reference | Reference |
| 500–<1,000 | 328 (5%) | 168 (6%) | 160 (5%) | 1.36 (1.09–1.70)* | 1.54 (1.17–2.01)* | |
| 1,000–<10,000 | 814 (13%) | 456 (15%) | 358 (10%) | 1.65 (1.42–1.92)* | 1.92 (1.58–2.33)* | |
| ≥10,000 | 554 (9%) | 341 (11%) | 213 (6%) | 2.07 (1.73–2.49)* | 2.23 (1.75–2.83)* | |
| Unknown | 253 (3%) | 102 (3%) | 151 (4%) | |||
| Ruptured membranes in labor | No | 3,289 (51%) | 2,312 (76%) | 977 (29%) | Reference | Reference |
| Yes | 2,900 (45%) | 627 (21%) | 2,273 (66%) | 0.12 (0.10–0.13)* | 0.12 (0.11–0.14)* | |
| Unknown | 255 (4%) | 86 (3%) | 169 (5%) | |||
| Gestational age at delivery (weeks) | <32 | 244 (4%) | 100 (3%) | 144 (4%) | Reference | Reference |
| 32–<37 | 950 (15%) | 487 (16%) | 463 (14%) | 1.52 (1.14–2.01)* | 1.89 (1.32–2.70)* | |
| 37–<40 | 3,933 (61%) | 2,020 (67%) | 1,913 (56%) | 1.52 (1.17–1.98)* | 1.53 (1.10–2.13)* | |
| ≥40 | 1,314 (20%) | 415 (14%) | 899 (26%) | 0.67 (0.50–0.88)* | 0.94 (0.66–1.34) | |
| Unknown | 3 (0%) | 3 (0%) | 0 |
Multivariable logistic regression models adjusted for the following variables, namely maternal age at delivery, timing of HIV diagnosis, initial trimester of ARV use, first CD4 cell count in pregnancy, last HIV viral load before delivery, gestational age at delivery, HIV treatment guideline period; and ruptured membranes in labor.
The final n in the adjusted regression model was 5,836HIV-infected women, which included complete cases without missing data.
Reflects statistically significant findings with a p-value<0.05.
All percentages shown are column percentages. Variables with missing data were included in frequencies and percentages, but not in the regression models used to calculate the OR, 95% CI.
The following abbreviations are used in the table above: highly active antiretroviral therapy (HAART) and antiretroviral (ARV), protease inhibitor (PI), non-nucleoside reverse transcriptase inhibitor (NNRTI), and nucleoside reverse transcriptase inhibitor (NRTI).