Each year hundreds of thousands of babies are born infected with HIV around the globe. Hundreds of them are right here. The implications of this are shocking and terrifying. Without a reliable cure on the horizon, these children are destined for shortened, difficult lives. What if the infection could have been prevented, however? What if those babies had not contracted their mother’s disease? As the world fights to find a way to save the millions of lives lost to complications from AIDS each year, what can be done to prevent maternal transference of the HIV virus to babies?

The fact that a woman is HIV positive does not mean her baby will absolutely contract the virus. Across a variety of clinical settings, the instance of maternal transmission of the HIV virus to her baby is between 14% and 42% when she goes without intervention. Approximately one third of these transmissions will occur at some point during gestation, while the other two thirds will occur during birth. It is impossible to know when the transmission will occur, so various measures are generally recommended to give the baby the best chances of not contracting the virus. As some babies contract the virus from the breast milk of a mother who is HIV positive, doctors recommend these mothers do not breastfeed, and continue to administer treatment for six weeks after the baby is born.

A primary form of treatment to help prevent the transmission of the HIV virus from mother to child is the administering of zidovudine throughout the pregnancy and through until the baby is six weeks old. The antiviral course of treatment is generally begun between the 14th and 34th week of pregnancy. This course of treatment has been shown to reduce the instance of gestational transmission up to 65%. Another highly effective method of reducing maternal transmission of the virus is through elective C-section. A mother who is shown to be HIV positive will be strongly encouraged to schedule a C-section close to her due date so the baby can be born prior to labor beginning. Links have been made between increased risk of transmission from mothers whose membranes have ruptured, particularly when there is an extended period between the rupture and the birth. Mothers are encouraged to have C-sections prior to the onset of labor to reduce this risk.

Source: Kourtis, Athena, et al. Understanding the Timing of HIV Transmission from Mother to Infant, Journal of American Medical Association, 2001; 285(6): 709-712.