吉林省HIV感染孕产妇人工终止妊娠及抗病毒治疗的影响因素研究  

Antiretroviral treatment and artificial termination of pregnancy among HIV-positive pregnant women and associated factors in Jilin province

作　　者：尹宝萍 万立新[2] 徐洪芹 易立岩[2] YIN Baoping;WAN Lixin;XU Hongqin;YI Liyan(Institute of Population Life Science and Technology of Jilin,Changchun 130041,China;Maternal and Child Health Hospital of Jilin Province,Changchun 130061,Jilin;The First Hospital of Jilin University,Changchun 130021)

机构地区：[1]吉林省人口生命科学技术研究院吉林省生殖保健医院,长春130041 [2]吉林省妇幼保健院吉林省产科质量控制中心,长春130061 [3]吉林大学第一医院肝胆胰内科,长春130021

出　　处：《中国艾滋病性病》2021年第3期225-228,共4页Chinese Journal of Aids & STD

基　　金：吉林省继续医学教育项目(20201203002)。

摘　　要：目的分析2006-2019年吉林省感染艾滋病病毒(HIV)的孕产妇人工终止妊娠及抗病毒治疗(ART)影响因素。方法利用预防艾滋病、梅毒和乙肝母婴传播管理信息系统数据,用卡方检验对HIV感染的孕产妇人工终止妊娠及ART相关因素暴露情况进行分析,采用Logistic回归的统计方法进行多因素分析,校正混杂因素。结果2006-2019年,吉林省有明确妊娠结局的感染HIV孕产妇共175人,50人(28.57%)选择人工终止妊娠;分娩的120人孕产妇中68人(56.67%)接受了ART。HIV感染孕产妇人工终止妊娠多因素分析显示,年度是人工终止妊娠的危险因素[比值比(OR)=2.319,95%可信区间(CI):1.143~4.705,P=0.020];2006-2015年、2016-2019年HIV感染孕产妇人工终止妊娠比例分别为21.57%、38.36%。人工终止妊娠的孕产妇中,初婚、再婚占21.01%,未婚、离婚、同居占56.76%,在婚是保护因素[比值比(OR)=0.199,95%可信区间(CI):0.091~0.437,P<0.001]。ART多因素分析显示,年度、本次妊娠检测时期是ART的危险因素(OR=3.677,95%CI:1.341~10.088,P=0.011;OR=10.020,95%CI:4.040~24.850,P<0.001)。2006-2015年、2016-2019年HIV感染孕产妇ART比例分别为42.11%、81.82%。本次妊娠孕期确诊的HIV感染孕产妇ART比例为82.81%,产时、产后等时期确诊的孕产妇ART比例为26.79%。结论 2006-2019年,吉林省未婚、离婚、同居的HIV感染孕产妇人工终止妊娠比例高于初婚、再婚的感染孕产妇。孕期确诊的HIV感染孕产妇ART比例高于产时、产后等时期确诊的感染孕产妇。Objective To analyze the influence factors of artificial termination of pregnancy and antiretroviral treatment(ART) among HIV+ pregnant women in Jilin from 2006 to 2019. Methods The data were collected from the Management Information System of China’s Prevention of Mother-to-Child Transmission of HIV/Syphilis and Hepatitis B Program, to analyze the artificial termination and ART with the chi-square test. And the logistic regression statistical method was used for multivariate analysis. Results There were 175 HIV+ pregnant women with pregnancy outcomes reported from 2006 to 2019, and 50 of them chose artificial termination. Of the 120 cases who delivered, 68(56.67%)received ART. Multivariate analysis of artificial termination among HIV+ pregnant women showed that the year of diagnosis was a risk factor for artificial termination(OR=2.319, 95%CI: 1.143-4.705, P=0.020). The rate of HIV+pregnant women with artificial termination during 2016-2019 was higher than that during 2006-2015, 38.36% and 21.57%respectively. The first marriage and remarriage accounted for 21.01% among the HIV+ women with artificial termination,and the single, divorced and cohabitant pregnant women for 56.76%. Marriage was a protective factor for artificial termination(OR=0.199, 95%CI: 0.091-0.437, P<0.001).Multivariate analysis of ART showed that the year of diagnosis and the pregnancy test period were risk factors for ART(OR=3.677, 95%CI: 1.341-10.088, P=0.011;OR=10.020, 95%CI: 4.040-24.850, P<0.001).The rate of HIV+ pregnant women with ART during 2016-2019 was higher than that during 2006-2015, 81.82% and 42.11% respectively. The rate of HIV+ pregnant women diagnosed in pregnancy and with ART was higher than that during and after delivery, 82.81% and 26.79% respectively.Conclusion From 2006 to 2019, the rate of single, divorced and cohabitant pregnant women is higher than that of married and remarried HIV+ pregnant women with artificial termination of pregnancy. The rate of HIV+ pregnant women diagnosed in pregnancy with ART is higher than

关 键 词：艾滋病病毒 孕产妇 人工终止妊娠 抗病毒治疗 

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