The rate of health problems caused by cesarean sections is 60 percent higher among HIV-infected women compared to those not infected with the virus, according to research published in the August issue of Obstetrics and Gynecology.

After undergoing C-section deliveries, Judette Louis, MD, of Case Western Reserve University in Cleveland, Ohio, and her colleagues report, positive women were more likely to experience swelling of the uterus lining (endometritis), require blood transfusions, develop sepsis, and be treated for pneumonia—along with a slightly higher risk of death. The study, which took place from 1999 to 2002, followed 378 HIV-positive women and 54,281 uninfected women.

The researchers suggest that antiretroviral therapy alone substantially reduces the risk of mother-to-child HIV transmission, rendering C-sections unnecessary in most circumstances. Perinatal treatment guidelines, maintained by the U.S. Department of Health and Human Services, agree.