| 李辉霞,郑剑飞,黄广文,肖娟,王华,杨敏,冯娜.湖南省2011-2017年孕产妇HIV感染者早产、低出生体重和小于胎龄儿发生率及其影响因素分析[J].中华流行病学杂志,2018,39(10):1368-1374 |
| 湖南省2011-2017年孕产妇HIV感染者早产、低出生体重和小于胎龄儿发生率及其影响因素分析 |
| Prevalence and associated risk factors on preterm birth, low birth weight, and small for gestational age among HIV-infected pregnant women in Hunan province, 2011-2017 |
| 收稿日期:2018-03-14 出版日期:2018-10-23 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.10.015 |
| 中文关键词: HIV感染 孕产妇 早产 低出生体重 小于胎龄儿 |
| 英文关键词: HIV infection Pregnant women Preterm birth Low birth weight Small for gestational age |
| 基金项目:预防艾滋病、梅毒和乙肝母婴传播项目 |
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| 中文摘要: |
| 目的 了解湖南省孕产妇HIV感染者早产、低出生体重（LBW）和小于胎龄儿（SGA）的发生状况并探讨其影响因素。方法 以2011年1月至2017年12月湖南省预防艾滋病母婴传播管理信息系统报告的已分娩的孕产妇HIV感染者为研究对象，对其人口学特征、妊娠情况、抗病毒治疗（ART）、丈夫/性伴情况和妊娠结局等因素进行分析，分别计算早产、LBW和SGA发生率，采用多因素logistic回归分析其相关影响因素。结果 共纳入780例孕产妇HIV感染者，其早产率为7.9%（62/780），LBW发生率为9.9%（77/780），SGA发生率为21.3%（166/780）。孕产妇HIV感染者早产的危险因素包括妊娠期中重度贫血、妊娠期高血压疾病、<14孕周开始ART（与孕期未进行ART相比）和丈夫/性伴年龄>35岁（与26~30岁相比），其aOR值分别为4.59（95% CI：1.51~13.95）、4.90（95% CI：1.56~15.46）、2.40（95% CI：1.26~4.56）和2.29（95% CI：1.21~4.36）。妊娠期中重度贫血、妊娠合并HBV感染和<14孕周开始ART（与孕期未进行ART相比）是LBW的危险因素，其aOR值分别为3.28（95% CI：1.13~9.54）、4.37（95% CI：1.42~13.44）和2.68（95% CI：1.51~4.76）。妊娠合并HBV感染和<14孕周开始ART（与孕期未进行ART相比）是SGA的危险因素，其aOR值分别为4.41（95% CI：1.43~13.63）和2.67（95% CI：1.51~4.73）。结论 早产、LBW和SGA是湖南省孕产妇HIV感染者常见的不良妊娠结局，受妊娠合并症、ART和丈夫/性伴的年龄等因素影响。 |
| 英文摘要: |
| Objective To describe the prevalence of preterm birth (PB), low birth weight (LBW), and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province. Methods This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province, between January 2011 and December 2017. Information regarding demographic characteristics, pregnancy, antiretroviral therapy (ART), husbands/partners' relevant situation and pregnancy outcomes, among these HIV-infected pregnant women were collected and analyzed. The incidence rates on PB, LBW and SGA were calculated. Multivariate logistic regression was used to analyze the associated risk factors. Results A total of 780 HIV-infected pregnant women were enrolled. The prevalence rates on PB, LBW and SGA in HIV-infected pregnant women appeared as 7.9% (62/780), 9.9% (77/780) and 21.3% (166/780), respectively. Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia, hypertensive, initial time of ART <14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age >35 years old (compared to husbands/partners' age 26-30 years old) etc., were associated with an increased risk of PB with adjusted OR as 4.59 (95% CI:1.51-13.95), 4.90 (95% CI:1.56-15.46), 2.40 (95% CI:1.26-4.56) and 2.29 (95% CI:1.21-4.36). For LBW, pregnancy moderate/severe anemia, pregnancy HBV infection and initial time of ART <14 gestational weeks were associated with an increased risk of LBW, with adjusted OR as 3.28 (95% CI:1.13-9.54), 4.37 (95% CI:1.42-13.44) and 2.68 (95% CI:1.51-4.76), respectively. For SGA, pregnancy HBV infection and initial time of ART <14 gestational weeks were risk factors for SGA, with adjusted OR as 4.41 (95% CI:1.43-13.63) and 2.67 (95% CI:1.51-4.73), respectively. Conclusion Preterm birth, LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications, ART and husbands/partners' age. |
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