| 高雅,王潇滟,高群,黄东旭,王前,王雨,郑洪巧,李昕薇,付彩云,张紫琦,王爱玲.中国2019年HIV感染孕产妇所生儿童的失访状况及影响因素分析[J].Chinese journal of Epidemiology,2024,45(6):833-838 |
| 中国2019年HIV感染孕产妇所生儿童的失访状况及影响因素分析 |
| Analysis of loss to follow-up status and influencing factors of children born to pregnant women with HIV infection in China in 2019 |
| Received:January 05, 2024 |
| DOI：10.3760/cma.j.cn112338-20240105-00005 |
| KeyWord: 艾滋病病毒 母婴传播 HIV暴露儿童 失访 影响因素 |
| English Key Word: HIV Mother-to-child transmission HIV-exposed children Loss to follow-up Influencing factors |
| FundProject: |
| Author Name | Affiliation | E-mail | | Gao Ya | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Wang Xiaoyan | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Gao Qun | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Huang Dongxu | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Wang Qian | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Wang Yu | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Zheng Hongqiao | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Li Xinwei | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Fu Caiyun | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Zhang Ziqi | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | | | Wang Ailing | National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China | ailing@chinawch.org.cn |
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| Abstract: |
| 目的 分析2019年中国HIV感染孕产妇所生儿童（HIV暴露儿童）的失访状况及影响因素。方法 资料来源于我国预防艾滋病、梅毒和乙型肝炎母婴传播管理信息系统2019年全国医疗机构报告的HIV感染孕产妇和HIV暴露儿童的基本信息和随访记录，HIV暴露儿童失访的定义为出生后满18月龄无法随访到且21月龄时仍未随访到的存活儿童。采用回顾性资料分析方法，HIV暴露儿童的失访影响因素分别采用χ2检验和logistic回归模型进行单因素和多因素分析。采用SPSS 25.0软件进行统计学分析。结果 在5 039例HIV感染孕产妇中，分娩的HIV暴露儿童5 035例，HIV暴露儿童的失访率为5.62%（283/5 035）。多因素logistic回归分析结果显示，孕产妇职业为农（牧、渔）民（aOR=0.34，95%CI：0.22~0.53）、婚姻状况为未婚（aOR=0.47，95%CI：0.24~0.93）、初婚（aOR=0.38，95%CI：0.22~0.67）、再婚（aOR=0.36，95%CI：0.20~0.67）与同居（aOR=0.47，95%CI：0.23~0.97）和本次妊娠前知晓自己感染HIV（aOR=0.53，95%CI：0.40~0.70）的HIV暴露儿童失访率较低；孕产妇为汉族（aOR=1.52，95%CI：1.09~2.13）、小学（aOR=2.06，95%CI：1.10~3.89）和初中文化程度（aOR=1.81，95%CI：1.03~3.17）、未抗病毒治疗（aOR=6.21，95%CI：4.32~8.93）和在乡（街道）级助产机构分娩（aOR=5.72，95%CI：1.61~20.27）的HIV暴露儿童失访率较高。结论 2019年我国HIV暴露儿童存在一定的失访，为进一步降低其失访率，提高妇女孕前HIV检测率和HIV感染孕产妇的抗病毒治疗率，对有效实施预防艾滋病母婴传播综合干预措施有重要意义。 |
| English Abstract: |
| Objective To understand the loss to follow-up of children born to pregnant women with HIV infection (HIV-exposed children) and analyze its influencing factors in China in 2019. Methods The data were collected from the follow-up records of pregnant women with HIV infection and their children reported by the national "Management Information System for the Prevention of HIV, syphilis and Hepatitis B Mother-to-Child Transmission" in 2019. HIV-exposed children were defined as those who were not followed up after birth or who were not followed up at 18 months of age and who were not followed up at 21 months of age. The univariate and multivariate influencing factors of loss to follow-up of children born to HIV-infected pregnant women were analyzed by χ2 test and logistic regression model. SPSS 25.0 software was used for statistical analysis. Results The number of HIV-infected pregnant women was 5 039, the number of live-born children was 5 035, the number of loss to follow-up children within 18 months of age was 283, and the loss to follow-up rate children was 5.62%(283/5 035). The results of multivariate logistic regression analysis showed that the rate of loss to follow-up of exposed children born to pregnant women who worked as farmers (animal husbandry and fishery) (aOR=0.34, 95%CI: 0.22-0.53), unmarried (aOR=0.47, 95%CI: 0.24-0.93), first marriage (aOR=0.38, 95%CI: 0.22-0.67), remarriage (aOR=0.36, 95%CI: 0.20-0.67) and cohabiting (aOR=0.47, 95%CI: 0.23-0.97), and knew they had HIV infection before this pregnancy (aOR=0.53, 95%CI: 0.40-0.70) was lower. Han nationality (aOR=1.52, 95%CI: 1.09-2.13), primary school (aOR=2.06, 95%CI: 1.10-3.89) and junior middle school (aOR=1.81, 95%CI: 1.03-3.17) educational level, non-use of antiviral drugs (aOR=6.21, 95%CI: 4.32-8.93) and delivery in township (street) level midwifery institutions (aOR=5.72, 95%CI: 1.61-20.27) had higher rates of loss to follow-up among infants born to HIV-infected pregnant women. Conclusions HIV-exposed children still have a specific rate of loss to follow-up in China in 2019. In order to further reduce the rate of loss to follow-up, it is of great significance to improve the detection rate of HIV before pregnancy and the rate of antiviral drugs used in pregnant women with HIV infection, which is of great significance for the effective implementation of comprehensive intervention measures of prevention of mother-to-child transmission of HIV. |
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