孕妇HIV疾病状况与新生儿LBW的相关性  

Relationship between HIV Status of Pregnant Women and LBW of Newborn

作　　者：吴爱辉 苏红春 王烨 李乐 马海燕 何贤静 WU Ai-hui;SU Hong-chun;WANG Ye;LI Le;MA Hai-yan;HE Xian-jing(Dept.of Obstetrics and Gynecology,The Third People’s Hospital of Kunming,Kunming Yunnan 650041,China)

机构地区：[1]昆明市第三人民医院妇产科,云南昆明650041

出　　处：《昆明医科大学学报》2020年第11期124-129,共6页Journal of Kunming Medical University

基　　金：昆明市科技计划基金资助项目(2017-1-S-15973号)。

摘　　要：目的分析HIV阳性孕妇所生新生儿的低出生体重(low birth weight,LBW)情况及其相关的危险因素。方法选择2013年1月至2018年5月于昆明市第三人民医院住院分娩的194例HIV阳性孕妇为研究对象。孕妇信息包括人口特征、妇产科病史、抗逆转录病毒药物史、HIV传播途径以及HIV疾病状况(包括入组时的CD4计数、HIV RNA病毒载量和血红蛋白)。采用Logistic回归分析确定与LBW相关的危险因素。结果在194名婴儿中,38例(19.6%)为LBW(<2500 g)。LBW婴儿与非LBW婴儿在入组体重、怀孕期间抗逆转录病毒药物治疗、入组CD4计数、入组HIV RNA病毒载量和分娩时孕龄差异均有统计学意义(P<0.05)。多变量Logistic回归分析显示,入组时体重轻(OR=2.14,95%CI=0.84~4.05,P=0.013)、入组时CD4计数(OR=6.02,95%CI=1.50~24.13,P<0.001)、入组时HIV RNA病毒载量(OR=3.34,95%CI=1.70~6.55,P<0.001)和分娩时孕龄(OR=12.90,95%CI=2.03~81.88,P<0.001)是LBW的独立危险因素。结论孕妇HIV疾病状况与新生儿LBW相关。HIV的产前筛查和诊断,对于早期预防和治疗HIV母婴传播,减少不良妊娠结局至关重要。Objective To analyze the low birth weight(LBW)situation and related risk factors of newborns born to HIV-positive pregnant women.Methods A total of 194 HIV-positive pregnant women who were hospitalized in Kunming Third People’s Hospital for delivery from January 2013 to May 2018 were selected as the research subjects.Information on pregnant women includes demographic characteristics,history of obstetrics and gynecology,history of antiretroviral drugs,HIV transmission route,and HIV disease status(including CD4 count,HIV RNA viral load and hemoglobin at the time of enrollment).Logistic regression analysis was used to determine the risk factors related to LBW.Results Among 194 infants,38(19.6%)were LBW(<2500 g).There were significant differences between LBW infants and non-LBW infants in entry weight,antiretroviral treatment during pregnancy,entry CD4 count,entry HIV RNA viral load and gestational age at delivery(P<0.05).Multivariate logistic regression analysis showed that the body weight was light at entry(OR=2.14,95%CI=0.84~4.05,P=0.013),and CD4 count at entry(OR=6.02,95%CI=1.50~24.13,P<0.001),HIV RNA viral load at entry(OR=3.34,95%CI=1.70~6.55,P<0.001)and gestational age at delivery(OR=12.90,95%CI=2.03~81.88,P<0.001)were independent risk factor for LBW.Conclusions The status of HIV disease in pregnant women is related to neonatal LBW.Prenatal screening and diagnosis of HIV are essential for the early prevention and treatment of mother-to-child transmission of HIV and reducing adverse pregnancy outcomes.

关 键 词：低出生体重(LBW) 怀孕 危险因素 HIV阳性 产前抗逆转录病毒治疗 

分 类 号：R714.7[医药卫生—妇产科学]