文章摘要
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
投稿时间:2018-03-14  
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
作者单位E-mail
李辉霞 410008 长沙, 湖南省妇幼保健院儿童保健部  
郑剑飞 410011 长沙, 中南大学湘雅二医院急诊科  
黄广文 410008 长沙, 湖南省妇幼保健院儿童保健部  
肖娟 410008 长沙, 湖南省妇幼保健院儿童保健部  
王华 410008 长沙, 湖南省妇幼保健院孕产保健部 wanghsfy@163.com 
杨敏 410008 长沙, 湖南省妇幼保健院孕产保健部  
冯娜 518067 深圳市南山区妇幼保健院保健部  
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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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