Steps to Reduce Rise of AIDS in Babies Urged

The Los Angeles City/County AIDS Task Force on Friday urged prospective parents and the medical community to take immediate steps to help reduce the expected rise in the number of babies born with the AIDS virus.

As of this week, 444 childhood acquired immune deficiency syndrome cases have been reported, including 15 in Los Angeles County. But the U.S. Public Health Service estimates that there will be 3,000 babies and young children with AIDS by 1991.

At a press conference in Los Angeles, task force chairman Dr. Neil R. Schram said doctors should start asking all prospective parents questions to determine if they have engaged in high-risk behaviors, such as intravenous drug use or having multiple sex partners. He said the task force plans to distribute a model questionnaire for physicians.

The task force also recommended that prospective parents found to be at risk for AIDS volunteer for the AIDS antibody blood test, postpone pregnancy and use condoms if either parent tests positive.

Doctors should also counsel pregnant women who test positive for AIDS antibodies about the possibility of abortion, the task force said. This is not only because of the risk to the baby, but because pregnancy appears to increase an infected women’s chances of developing AIDS. Adults who test positive are estimated to have a 30% to 50% chance of becoming ill with AIDS within five years.

The task force did not advocate abortions but said physicians had an obligation to advise parents of the health risks of continuing the pregnancy.

“This is standard medical practice,” Schram said.

Schram made similar remarks earlier this week to the Daily News, which upset anti-abortion activists.

“You don’t cure AIDS by killing the patient,” said Susan Carpenter-McMillan, a spokeswoman for the Right to Life League in Los Angeles. But the Right to Life League “agrees totally” with the task force’s other recommendations, she said.

Public health officials estimate that about 50% of infected mothers who test positive for AIDS antibodies will transmit the infection to their children and that about half of the infected newborns will die within the first 15 months of life.

“The little ones who are infected move more rapidly to the end-stage than adults,” said task force member Dr. Edward Gomperts of Childrens Hospital of Los Angeles.

Most of the 15 children in Los Angeles County have been infected through contaminated blood transfusions, in contrast to the rest of the country, where most cases have been transmitted from a woman to her fetus.

Now that the risk of AIDS virus infection from blood transfusions has become minimal, because of better screening techniques, public health officials believe that targeting prospective parents is the best way to prevent further cases.

“In the majority of situations, the parents are not aware (that they may be carrying the virus),” Gomperts said. “In some situations, there is a strong component of denial.”

It is currently not recommended that fetal blood samples be obtained during pregnancy to check for the AIDS virus, according to Dr. Lawrence D. Platt, an expert in fetal medicine at the County-USC Medical Center. Prenatal diagnostic tests are commonly done for other conditions to help counsel patients about terminating pregnancy.

The procedures to obtain blood from the umbilicus may contaminate the fetus with the mother’s blood that contains the AIDS virus, and even if the fetus tests negative, the transmission of the virus may occur later in pregnancy, Platt said.