人类免疫缺陷病毒阳性孕妇所生婴儿的出生体质量及其影响因素  

Birth weight of infants born to pregnant women living with human immunodeficiency virus and its associated factors

作　　者：刘金丽 吴松杰[2] 邹诗 冯玲[1] 严亚军[1] 谭雨亭 明方昭 骆明其 梁科[1] Liu Jinli;Wu Songjie;Zou Shi;Feng Ling;Yan Yajun;Tan Yuting;Ming Fangzhao;Luo Mingqi;Liang Ke(Department of Infectious Diseases,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Nosocomial Infection Management,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of AIDS Prevention and Treatment,Wuchang District Center for Disease Control and Prevention,Wuhan 430060,China)

机构地区：[1]武汉大学中南医院感染科,武汉430071 [2]武汉大学中南医院医院感染管理办公室,武汉430071 [3]武汉市武昌区疾病预防控制中心艾滋病防治科,武汉430060

出　　处：《中华传染病杂志》2023年第6期401-406,共6页Chinese Journal of Infectious Diseases

基　　金：武汉大学中南医院2020年度医学科技创新平台支撑项目(PTXM2020008)。

摘　　要：目的分析人类免疫缺陷病毒(HIV)阳性孕妇所生婴儿的出生体质量及其影响因素,为我国HIV感染的母婴传播阻断工作提供参考。方法本研究为回顾性队列研究。纳入2004年1月至2021年12月湖北省确诊HIV阳性的孕妇及其所生婴儿,随访并通过医院病历和艾滋病综合防控数据信息管理系统收集临床资料。采用多元线性回归进行出生体质量的相关影响因素分析。结果共纳入531例HIV阳性孕妇(581孕次)及其所生581名婴儿。581名婴儿中,36例HIV阳性,母婴传播率为6.2%。婴儿的出生体质量为(3075.0±470.2)g。孕妇接受基于蛋白酶抑制剂(PI)的抗反转录病毒治疗(ART)[β=-0.1,95%可信区间(95%CI)-188.2~-37.1,P=0.004]、在妊娠早期接受ART(β=-0.1,95%CI-201.9~-65.5,P<0.001)、HIV阳性婴儿(β=-0.1,95%CI-310.4~-68.2,P=0.002)、孕妇丙型肝炎病毒(HCV)感染(β=0.1,95%CI 71.2~410.4,P=0.005)和出生孕周(β=0.6,95%CI 155.9~191.5,P<0.001)与婴儿出生体质量的降低有关。结论在加强HIV母婴传播阻断效果的同时,应对妊娠早期接受ART和接受基于PI的ART方案治疗的孕妇及其所生婴儿给予更多关注,从而减少出生体质量下降的发生,促进母婴健康。Objective To investigate the birth weight(BW)of infants born to pregnant women living with human immunodeficiency virus(HIV)and its associated factors,and to provide more evidence for the prevention of mother-to-child transmission(PMTCT)in China.Methods This study was a retrospective cohort study.Between January 2004 and December 2021,pregnant women living with HIV and their infants in Hubei Province were recruited and followed up,and clinical data were collected through hospital medical records and HIV/acquired immunodeficiency syndrome comprehensive response information management system.The multivariable linear regression was performed on the collected data to investigate associated influencing factors of BW.Results In total,531 pregnant women living with HIV(581 pregnancies)and 581 infants were enrolled.Of the 581 infants,36 were HIV-positive,with a PMTCT rate of 6.2%.The mean BW of the infants was(3075.0±470.2)gram.Protease inhibitor(PI)based-anti-retroviral therapy(ART)(β=-0.1,95%confidence interval(CI)-188.2 to-37.1,P=0.004),ART in the first trimester(β=-0.1,95%CI-201.9 to-65.5,P<0.001),infant HIV infection(β=-0.1,95%CI-310.4 to-68.2,P=0.002),hepatitis C virus infection(β=0.1,95%CI 71.2 to 410.4,P=0.005)and gestational age(β=0.6,95%CI 155.9 to 191.5,P<0.001)were associated with decreased BW.Conclusions While improving the effectiveness of PMTCT for HIV,more attention should be paid to pregnant women who received ART in the first trimester and PI-based ART for preventing lower BW and improving maternal and infantile health.

关 键 词：HIV 出生体重 母婴传播阻断 蛋白酶抑制药 

分 类 号：R512.91[医药卫生—内科学]