SynthesisAIDS (London, England)2017
Elective cesarean section for women living with HIV: a systematic review of risks and benefits.
Synthesis in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Estimating the effect of maternal viral load on perinatal and postnatal HIV transmission: a systematic review and meta-analysis.Lancet (London, England) · 2025Pooled it
- ISIDOG Recommendations Concerning COVID-19 and Pregnancy.Diagnostics (Basel, Switzerland) · 2020Guideline
- Childbirth experiences for women living with HIV in Kilimanjaro, Tanzania: a mixed method study on respectful maternity care.International health · 2025Article
- HIV and Maternal-Fetal Immunity: Challenges and Strategies for Reducing Vertical Transmission-A Narrative Review.Health science reports · 2025Article
- How cesarean section rates can be reduced through an effective financial strategy: A protocol for systematic review.Medicine · 2025Article
- Enhancing Public Health Strategies to Prevent Mother-to-Child Transmission of HIV: Insights from a Cohort Study in Iran.Medical journal of the Islamic Republic of Iran · 2025Article
- Update on HIV prevention and management in pregnancy Number 10 - 2025.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Article
- HIV infection during pregnancy in the state of Rio de Janeiro, Brazil, 2021-2023.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2025Article
- Prenatal ultrasound screening and pregnancy outcomes in HIV-positive women in Germany: results from a retrospective single-center study at the Charité-Universitätsmedizin Berlin.Archives of gynecology and obstetrics · 2024Article
- Outcomes of the MAMA Training: A Simulation and Experiential Learning Intervention for Labor and Delivery Providers to Improve Respectful Maternity Care for Women Living with HIV in Tanzania.AIDS and behavior · 2024Article
- Fetal Growth Restriction and Clinical Parameters of Newborns from HIV-Infected Romanian Women.Medicina (Kaunas, Lithuania) · 2023Article
- Pregnancy incidence, outcomes and associated factors in a cohort of women living with HIV/AIDS in Rio de Janeiro, Brazil, 1996-2016.Cadernos de saude publica · 2023Article
- Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania.Medicina (Kaunas, Lithuania) · 2022Article
- ESHRE guideline: medically assisted reproduction in patients with a viral infection/disease.Human reproduction open · 2021Article
- Understanding Viral and Immune Interplay During Vertical Transmission of HIV: Implications for Cure.Frontiers in immunology · 2021Review
- Preventing mother to child transmission of HIV: lessons learned from China.BMC infectious diseases · 2020Article
- Impact of the Coronavirus Infection in Pregnancy: A Preliminary Study of 141 Patients.Journal of obstetrics and gynaecology of India · 2020Article
- Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol.Infection · 2019Article
- HIV infections and HIV testing during pregnancy, Germany, 1993 to 2016.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019Observational
- HIV viraemia during pregnancy in women receiving preconception antiretroviral therapy in KwaDukuza, KwaZulu-Natal.Southern African journal of HIV medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
OBJECTIVE AND
designTo inform WHO guidelines, we conducted a systematic review and meta-analysis to assess maternal and perinatal outcomes comparing cesarean section (c-section) before labor and rupture of membranes [elective c-section (ECS)] with other modes of delivery for women living with HIV.
methodsWe searched PubMed, CINAHL, Embase, CENTRAL, and previous reviews to identify published trials and observational studies through October 2015. Results were synthesized using random-effects meta-analysis, stratifying for combination antiretroviral therapy (cART), CD4/viral load (VL), delivery at term, and low-income/middle-income countries.
resultsFrom 2567 citations identified, 36 articles met inclusion criteria. The single randomized trial, published in 1999, reported minimal maternal morbidity and significantly fewer infant HIV infections with ECS [odds ratio (OR) 0.2, 95% confidence interval (CI) 0.0-0.5]. Across observational studies, ECS was associated with increased maternal morbidity compared with vaginal delivery (OR 3.12, 95% CI 2.21-4.41). ECS was also associated with decreased infant HIV infection overall (OR 0.43, 95% CI 0.30-0.63) and in low-income/middle-income countries (OR 0.27, 95% CI 0.16-0.45), but not among women on cART (OR 0.82, 95% CI 0.47-1.43) or with CD4 cell count more than 200/VL less than 400/term delivery (OR 0.59, 95% CI 0.21-1.63). Infant morbidity moderately increased with ECS.
conclusionAlthough ECS may reduce infant HIV infection, this effect was not statistically significant in the context of cART and viral suppression. As ECS poses other risks, routine ECS for all women living with HIV may not be appropriate. Risks and benefits will differ across settings, depending on underlying risks of ECS complications and vertical transmission during delivery. Understanding individual client risks and benefits and respecting women's autonomy remain important.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.