Abstract
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].Chinese journal of Epidemiology,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
Received:March 14, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2018.10.015
KeyWord: HIV感染  孕产妇  早产  低出生体重  小于胎龄儿
English Key Word: HIV infection  Pregnant women  Preterm birth  Low birth weight  Small for gestational age
FundProject:预防艾滋病、梅毒和乙肝母婴传播项目
Author NameAffiliationE-mail
Li Huixia Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China  
Zheng Jianfei Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China  
Huang Guangwen Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China  
Xiao Juan Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China  
Wang Hua Department of Maternal Health, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China wanghsfy@163.com 
Yang Min Department of Maternal Health, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China  
Feng Na Department of Health Care, Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen 518067, China  
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Abstract:
      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。
English Abstract:
      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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