CAJ | 학술논문

目的了解目前我国HIV感染孕产妇早产的流行情况并探讨其相关影响因素.方法数据来源于2013年我国预防艾滋病母婴传播管理信息系统.对HIV感染孕产妇的人口学特征、妊娠情况、HIV相关情况等变量进行分析,计算早产发生率并探讨相关影响因素.结果纳入分析的3 913例HIV感染孕产妇中有336例发生早产,早产率为8.6％.分析发现我国HIV感染孕产妇早产与年龄、民族、文化程度、人口流动状态、有无妊娠高血压、是否为多胎妊娠、孕期随访次数等因素之间存在关联,差异有统计学意义(P＜0.05);与吸毒感染HIV者相比,其他途径感染者早产率低(aOR=0.562,95％CI:0.360～0.879).在14 ～ 27孕周和在＜14孕周就已开始使用抗反转录病毒药物(ARV)的孕产妇同妊娠期间从未使用过ARV药物的孕产妇相比早产发生危险性增加,aOR直分别为1.712(95％CI:1.196～ 2.451)和1.862(95％CI:1.261～ 2.749).结论早产是我国HIV感染孕产妇常见不良妊娠结局之一.HIV感染孕产妇早产不仅与传统危险因素相关,还与HIV感染途径及孕期ARV药物服用情况相关.
목적 료해목전아국HIV감염잉산부조산적류행정황병탐토기상관영향인소.방법 수거래원우2013년아국예방애자병모영전파관리신식계통.대HIV감염잉산부적인구학특정、임신정황、HIV상관정황등변량진행분석,계산조산발생솔병탐토상관영향인소.결과 납입분석적3 913례HIV감염잉산부중유336례발생조산,조산솔위8.6％.분석발현아국HIV감염잉산부조산여년령、민족、문화정도、인구류동상태、유무임신고혈압、시부위다태임신、잉기수방차수등인소지간존재관련,차이유통계학의의(P＜0.05);여흡독감염HIV자상비,기타도경감염자조산솔저(aOR=0.562,95％CI:0.360～0.879).재14 ～ 27잉주화재＜14잉주취이개시사용항반전록병독약물(ARV)적잉산부동임신기간종미사용과ARV약물적잉산부상비조산발생위험성증가,aOR직분별위1.712(95％CI:1.196～ 2.451)화1.862(95％CI:1.261～ 2.749).결론 조산시아국HIV감염잉산부상견불량임신결국지일.HIV감염잉산부조산불부여전통위험인소상관,환여HIV감염도경급잉기ARV약물복용정황상관.
Objective To measure the incidence rates of preterm delivery in HIV-infected pregnant women and to explore related potential risk factors.Methods Data from 'Information System of Prevention of Mother-to-child Transmission of HIV Management in China,2013' was used in the study.Information regarding demographic characteristics,pregnancy,HIV relevant situations and pregnancy outcomes related to these HIV-infected pregnant women,were extracted and analyzed.Incidence of preterm delivery was calculated with related potential risk factors explored.Results 3 913 HIV-infected pregnant women were involved in this study,including 336 of them having undergone preterm deliveries (8.6％).Results from univariate and multivariate analyses showed that preterm delivery was associated with factors as:maternal age,ethnicity,education,being migrant,pregnancy hypertension,multiple pregnancy and times of antenatal care visits (P＜0.05) of the pregnant women.Compared with those who contracted the HIV infection through drug injection,the ones who were infected through other routes suffered fewer preterm deliveries (adjusted OR=0.562,95％CI:0.360-0.879).Pregnant women who received antiretroviral therapy either between 14to 27 gestational weeks or during the period of less than 14,were more likely to experience preterm delivery,comparison to those who did not receive the therapy during pregnancy.The adjusted ORs were 1.712(95％CI:1.196-2.451) and 1.862 (95％CI:1.261-2.749),respectively.Conclusion Preterm delivery was a common adverse outcome during pregnancy among HIV-infected women in China.Other than traditionally known risk factors,routes of transmission and the use of antiretroviral therapy might also be associated with the increased risks for preterm delivery.