Hospitalization of children born to human immunodeficiency virus-infected women in Europe

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Abstract
Objective. To describe the pattern of inpatient hospital service use in the first 5 years of life of all children born to HIV-infected women in 10 pediatric centers of the European Collaborative Study. Background. Little information is available on the need for hospitalization of children born to HIV-infected women, especially those uninfected, despite the fact that they may be at risk of social deprivation and poor health because of family circumstances. Methods. Data on 1189 children enrolled between 1986 and 1997 and followed prospectively since birth according to a standard protocol were analyzed. Results. This analysis included 151 HIV-infected and 811 uninfected children. One hundred forty (12%) infants had delayed postnatal discharge, mainly for drug withdrawal symptoms and prematurity. Uninfected children had 0.5 admission per 5 child years compared with 2.4 for infected children. From life table analysis, an estimated 48% of infected and 17% of uninfected children will have been admitted by age 12 months. Nearly 60% (3304 of 5604) of the total inpatient days of infected children occurred after AIDS diagnosis. Infected children were 4 times more likely to be hospitalized than uninfected children of the same age, and children with symptomatic mothers were 13 times more likely to be admitted for a nonmedical reason. Conclusions. Whereas hospitalization of infected children poses an expected burden on the health care system, the use of such services by uninfected children is largely explained by their social background and provides an argument for better support for families affected by HIV.