Enhanced Perinatal Surveillance (EPS)/Pediatric Spectrum of Disease (PSD)

Project Description

Stanford University manages the California* component of a 16-site nationwide perinatal surveillance program initiated by the Centers for Disease Control and Prevention (CDC). The EPS project collects confidential surveillance data on HIV-positive mothers and their HIV-exposed infants.

This program has many specific objectives:

To provide data to assist in the formulation of a perinatal prevention plan and to assist in the evaluation of prevention interventions for continued refinement of prevention activities.
To assess use of prenatal care by HIV-positive women and characterize the population of HIV-positive women for whom prenatal care is not timely and/or inadequate. (Hard to reach women, such as illicit drug users or incarcerated women, are target populations for prevention interventions.)
To determine the proportion of HIV-infected pregnant women giving birth each year that are known to be infected before delivery; to determine the proportion of pregnant HIV-infected women who were offered, accepted, and received HIV testing; to identify and characterize populations and health care settings where HIV testing is not timely; to identify populations of women who were not offered an HIV test or who refused and HIV test.
To determine the proportion of pregnant HIV-infected women who were offered, accepted, and received antiretroviral drugs during the prenatal and intrapartum periods, and whose children receive antiretroviral drugs postnatally; to identify and characterize populations and health care settings where maternal/neonatal antiretroviral drugs are less utilized; to identify populations of women who were not offered antiretroviral drugs, refused their use, and/or were noncompliant with their use.
To conduct follow-up of all HIV-exposed infants to determine their HIV infection status.
To estimate the effectiveness of ZDV and other antiretroviral drugs and evaluate changes in transmission rates due to receipt of these drugs.
To follow trends in rates of elective cesarean section and other interventions to reduce perinatal HIV transmission.
To determine the proportion of women who were tested at delivery, what kind of testing was conducted, if these test results are documented in the medical record; to characterize these women who receive HIV testing at delivery.
To characterize missed opportunities for prevention of perinatal HIV transmission.
To determine what proportion of HIV-infected women and HIV-exposed children are receiving follow-up care according to PHS guidelines (e.g., timeliness of initiation of HIV diagnostic testing, receipt of antiretroviral treatment, avoidance of breastfeeding, receipt of PCP prophylaxis).
If state laws permit, to assess any short-term (i.e. birth defects) or long-term (i.e. mutagenic carcinogenic, or mitochondrial) adverse effects related to in-utero exposure to ZDV and other antiretroviral drugs, particularly in HIV-uninfected infants (seroreverters).

For information about the EPS project please contact: Barbara Sullivan, RN; 650/ 723-5849.

*(except Los Angeles County)



		STANFORD UNIVERSITY, SCHOOL OF MEDICINE

		DEPARTMENT OF PEDIATRICS




			Project Description Stanford University manages the California* component of a 16-site nationwide perinatal surveillance program initiated by the Centers for Disease Control and Prevention (CDC). The EPS project collects confidential surveillance data on HIV-positive mothers and their HIV-exposed infants. This program has many specific objectives: To provide data to assist in the formulation of a perinatal prevention plan and to assist in the evaluation of prevention interventions for continued refinement of prevention activities. To assess use of prenatal care by HIV-positive women and characterize the population of HIV-positive women for whom prenatal care is not timely and/or inadequate. (Hard to reach women, such as illicit drug users or incarcerated women, are target populations for prevention interventions.) To determine the proportion of HIV-infected pregnant women giving birth each year that are known to be infected before delivery; to determine the proportion of pregnant HIV-infected women who were offered, accepted, and received HIV testing; to identify and characterize populations and health care settings where HIV testing is not timely; to identify populations of women who were not offered an HIV test or who refused and HIV test. To determine the proportion of pregnant HIV-infected women who were offered, accepted, and received antiretroviral drugs during the prenatal and intrapartum periods, and whose children receive antiretroviral drugs postnatally; to identify and characterize populations and health care settings where maternal/neonatal antiretroviral drugs are less utilized; to identify populations of women who were not offered antiretroviral drugs, refused their use, and/or were noncompliant with their use. To conduct follow-up of all HIV-exposed infants to determine their HIV infection status. To estimate the effectiveness of ZDV and other antiretroviral drugs and evaluate changes in transmission rates due to receipt of these drugs. To follow trends in rates of elective cesarean section and other interventions to reduce perinatal HIV transmission. To determine the proportion of women who were tested at delivery, what kind of testing was conducted, if these test results are documented in the medical record; to characterize these women who receive HIV testing at delivery. To characterize missed opportunities for prevention of perinatal HIV transmission. To determine what proportion of HIV-infected women and HIV-exposed children are receiving follow-up care according to PHS guidelines (e.g., timeliness of initiation of HIV diagnostic testing, receipt of antiretroviral treatment, avoidance of breastfeeding, receipt of PCP prophylaxis). If state laws permit, to assess any short-term (i.e. birth defects) or long-term (i.e. mutagenic carcinogenic, or mitochondrial) adverse effects related to in-utero exposure to ZDV and other antiretroviral drugs, particularly in HIV-uninfected infants (seroreverters). For information about the EPS project please contact: Barbara Sullivan, RN; 650/ 723-5849. *(except Los Angeles County)