2004-2016年湖北省520例HIV阳性孕妇流行病学特征及终止妊娠情况分析  

Analysis on epidemiological characteristics and termination of pregnancy in 520 HIV-positive pregnant women in Hubei from 2004 to 2016

作　　者：吴国敏[1] 桂希恩[2] 李家兵 刘佳荣 唐桂珍[5] 彭应玉 李蓉 刘正 韦涛[9] 梁科[1] WU Guo-Min;GUI Xi-En;LI Jia-Bing(Department of Infectious Diseases,Central South Hospital of Wuhan University,Wuhan,Hubei 430071,China)

机构地区：[1]武汉大学中南医院感染科,湖北武汉430071 [2]武汉大学中南医院艾培中心,湖北武汉430071 [3]恩施市妇幼保健院,湖北恩施445000 [4]南漳县妇幼保健院,湖北南漳441500 [5]十堰市疾病预防控制中心,湖北十堰442000 [6]广水市疾病预防控制中心,湖北广水432700 [7]荆州市荆州区妇幼保健院,湖北荆州434020 [8]武穴市疾病预防控制中心,湖北武穴435400 [9]昆明医科大学,云南昆明650021

出　　处：《中国妇幼保健》2019年第2期405-410,共6页Maternal and Child Health Care of China

基　　金：国家自然科学基金(81000758);中国性病艾滋病防治协会.艾伯维妇幼关爱及预防母婴传播基金(PMTCT2017-005);武汉中青年医学骨干人才项目

摘　　要：目的了解湖北省人类免疫缺陷病毒(HIV)阳性孕妇的流行病学特征及趋势,探讨终止妊娠情况及相关影响因素,为制定HIV母婴阻断工作策略提供依据。方法对湖北省部分地区2004年1月-2016年12月确诊的HIV阳性孕妇进行调查和随访,收集其流行病学等相关资料,检测其乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及梅毒合并感染状况,并对HIV阳性孕妇丈夫/性伴HIV感染状况进行检测,采用SPSS 20. 0统计软件对相关资料进行统计分析。结果 520例HIV阳性孕妇共妊娠603次。HIV阳性孕妇首次妊娠时,92. 88%已婚,74. 04%尚无子女。孕妇乙型肝炎病毒表面抗原(HBs Ag)、丙型肝炎病毒抗体(HCV-Ab)、梅毒螺旋体抗体(TP-Ab)阳性率分别为7. 67%、4. 69%、3. 40%,其丈夫/性伴HIV阳性率为26. 02%,性途径感染者472例(90. 77%),2004-2016年,性途径感染者所占比例逐年上升;血途径感染者所占比例逐年下降,2009年之后仅零星发现。2011年首次发现通过母婴途径感染HIV的孕妇。在2004-2007、2008-2011、2012-2016年三个时间段,产前确诊孕妇所占比例呈上升趋势,但孕早期确诊孕妇所占比例变化趋势不明显。HIV阳性孕妇自愿选择终止妊娠的比例为44. 94%,孕妇选择终止妊娠的比例逐年下降。多因素Logistic回归分析显示,未婚(P=0. 009)、已有子女(P=0. 000)、年龄≤20岁(P=0. 016)是HIV阳性孕妇选择终止妊娠的危险因素。结论性传播是湖北省HIV阳性孕妇感染HIV的主要途径。需加大孕期HIV筛查力度,尽早发现HIV阳性孕妇。随着HIV阳性孕妇选择终止妊娠率的下降,应为HIV阳性孕妇提供更优质的阻断服务。Objective To understand epidemiological characteristics and trend of HIV-positive pregnant women in Hubei,explore termination of pregnancy and related influencing factors,provide a basis for making measures to block mother-to-child transmission of HIV.Methods The HIV-positive pregnant women diagnosed definitely in partial areas of Hubei from January 2004 to December 2016 were surveyed and followed up,the epidemiological data were collected. The infection rates of HBV,HCV,and syphilis were detected. HIV infection rate of husbands/sexual partners of these HIV-positive pregnant women were detected. SPSS 20. 0 software was used to analyze the data.Results A total of 520 HIV-positive pregnant women were enrolled in this study,and they got pregnancy for 603 times. When they got pregnancy for the first time,92. 88% of them were married,and 74. 04% of them had no child. The positive rates of Hbs Ag,HCV-Ab,and TP-Ab were 7. 67%,4. 69%,and 3. 40%,respectively. The positive rate of husbands/sexual partners of these HIV-positive pregnant women was 26. 02%,472 cases (90. 77%) were infected through sexual activities. From 2004 to 2016,the proportion of cases infected through sexual activities increased year by year. The proportion of cases infected through blood transmission decreased year by year,which was very low after 2009. In 2011,pregnant women infected through mother-to-child transmission were observed for the first time. The proportion of pregnant women diagnosed definitely before delivery showed an increasing trend during three time periods (2004-2007,2008-2011,2012-2016). The changing trend of proportion of pregnant women diagnosed definitely during the first trimester of pregnancy was not obvious. Among these HIV-positive pregnant women,44. 94% of them terminated pregnancy voluntarily,the proportion decreased year by year. Multivariate logistic regression analysis showed that singlehood (P = 0. 009),having offsprings (P = 0. 000),and ≤20 years old (P =0. 016) were risk factors of pregnancy termination. Conclusion

关 键 词：孕妇 人类免疫缺陷病毒 流行病学 终止妊娠 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]