2013年至2019年成都市人类免疫缺陷病毒暴露未感染儿童体格生长发育的纵向研究  

Longitudinal study on growth of human immunodeficiency virus-exposed uninfected children from 2013 to 2019 in Chengdu City

作　　者：罗映娟 毛昂 杨柳 杨蕾 林永红 Luo Yingjuan;Mao Ang;Yang Liu;Yang Lei;Lin Yonghong(Health Care Department,Chengdu Women′s and Children′s Central Hospital,The Affiliated Women′s and Children′s Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610091,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院、成都市妇女儿童中心医院保健部,成都610091

出　　处：《中华传染病杂志》2023年第7期440-446,共7页Chinese Journal of Infectious Diseases

基　　金：中国疾病预防控制中心妇幼保健中心2022年度母婴营养与健康研究项目(2022FYH005);2021年成都市医学科研课题(2021354)。

摘　　要：目的纵向对比人类免疫缺陷病毒暴露未感染(HEU)组与健康对照组儿童0~18月龄的生长发育差异,以评估HEU儿童早期体格生长发育的情况。方法采用回顾性队列研究设计,收集2013年1月至2019年12月成都市出生并上报国家预防艾滋病、梅毒和乙肝母婴传播管理信息系统的人类免疫缺陷病毒(HIV)感染母亲的孕产期信息,以及其所生HEU儿童0、1、3、6、9、12、18月龄的随访信息,并按母亲分娩年龄、分娩孕周和出生性别1∶1匹配人类免疫缺陷病毒未暴露未感染(HUU)儿童作为健康对照组,HEU组与HUU组各纳入385名儿童。采用配对样本t检验、多水平模型比较两组儿童0~18月龄体格生长发育的差异。结果HEU组儿童0、3、6月龄的年龄别体重Z评分(WAZ)分别为-0.72±1.03、-0.09±1.18、0.05±1.09,分别低于HUU组的-0.21±1.04、0.42±1.19、0.41±1.16,差异均有统计学意义(t=8.41、7.47、5.18,均P<0.001);HEU组儿童3、6、12、18月龄的年龄别身长Z评分(LAZ)分别为-0.23±1.36、-0.01±1.48、-0.18±1.20、-0.32±1.13,分别低于HUU组的0.24±1.26、0.30±1.26、0.07±1.11、0.04±1.05,差异均有统计学意义(t=6.14、4.04、2.72、4.30,均P<0.01);HEU组儿童0、3、6月龄的身长别体重Z评分(WLZ)分别为-1.05±1.18、0.23±1.03、0.22±0.95,分别低于HUU组的-0.20±0.98、0.44±1.03、0.45±1.00,差异均有统计学意义(t=10.90、2.95、2.96,均P<0.01)。矫正可能的混杂因素后,HEU儿童0、3、6月龄WAZ,3、6、12、18月龄LAZ,以及0、3、6月龄WLZ仍分别低于HUU儿童。结论成都市HEU和HUU儿童的体格生长发育差异主要发生在婴儿早期6月龄内,但身长差异持续至18月龄。产前暴露于HIV感染会影响胎儿和出生后的体格生长发育。Objective To assess the early physical growth and development of human immunodeficiency virus-exposed uninfected(HEU)children by longitudinally comparing the differences of growth and development between HEU group and the healthy human immunodeficiency virus-unexposed uninfected(HUU)control group of children aged 0 to 18 months.Methods A retrospective cohort study was designed.Maternal information of the human immunodeficiency virus(HIV)infected mothers and follow-up information at 0,1,3,6,9,12,and 18 months postpartum of their children(born between January 2013 and December 2019 in Chengdu City)were collected from the Information System of Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus Management.The HUU control group was matched with HEU group by maternal age,gestational age at birth,and infant gender at a ratio of 1∶1.There were 385 children each included in the HEU and HUU groups.Matched samples t-test and the multilevel models were used to compared the physical developmental differences between the two groups.Results Weight for age Z scores(WAZ)at 0,3,6 months of HEU group were-0.72±1.03,-0.09±1.18 and 0.05±1.09,respectively,which were all lower than WAZ of HUU group(-0.21±1.04,0.42±1.19 and 0.41±1.16,respectively),which were all significantly different(t=8.41,7.47 and 5.18,respectively,all P<0.001).Length for age Z scores(LAZ)at 3,6,12,18 months of HEU group were-0.23±1.36,-0.01±1.48,-0.18±1.20 and-0.32±1.13,respectively,which were all lower than LAZ of HUU group(0.24±1.26,0.30±1.26,0.07±1.11 and 0.04±1.05,respectively),which were all significantly different(t=6.14,4.04,2.72 and 4.30,respectively,all P<0.01).Weight for length Z scores(WLZ)at 0,3,6 months of HEU group were-1.05±1.18,0.23±1.03 and 0.22±0.95,respectively,which were all lower than WLZ of HUU group(-0.20±0.98,0.44±1.03 and 0.45±1.00,respectively),which were all significantly different(t=10.90,2.95 and 2.96,respectively,all P<0.01).After possible confounding factors were corrected,the WAZ of HEU c

关 键 词：HIV 儿童 HIV暴露未感染 生长发育 多水平模型 

分 类 号：R512.91[医药卫生—内科学]