2017-2023年中国部分地区HIV感染孕产妇不良妊娠结局发生率及影响因素分析  

Analysis on rate of adverse pregnancy outcomes in HIV-infected pregnant women and influencing factors in some regions of China,2017-2023

作　　者：李昕薇 王爱玲 曹艳利 覃清华[3] 郑佳瑞[4] 谢小花[3] 艾比拜·买买提明 关灵灵 王潇滟 黄东旭 王前 Li Xinwei;Wang Ailing;Cao Yanli;Qin Qinghua;Zheng Jiarui;Xie Xiaohua;Aibibai Maimaitiming;Guan Lingling;Wang Xiaoyan;Huang Dongxu;Wang Qian(Chinese Center for Disease Control and Prevention,Beijing 102206,China;National Center for Women and Children's Health,National Health Commission,Beijing 100081,China;The Maternal and Child Health Care Center Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China;Yunnan Maternal and Child Health Care Center,Kunming 650051,China;Maternal and Child Health Care Center of Xinjiang Uygur Autonomous Region,Urumqi 830002,China)

机构地区：[1]中国疾病预防控制中心,北京102206 [2]国家卫生健康委妇幼健康中心,北京100081 [3]广西壮族自治区妇幼保健院,南宁530003 [4]云南省妇幼保健院,昆明650051 [5]新疆维吾尔自治区妇幼保健院,乌鲁木齐830002

出　　处：《中华流行病学杂志》2025年第1期125-130,共6页Chinese Journal of Epidemiology

摘　　要：目的了解我国HIV感染孕产妇不良妊娠结局发生率,探索影响因素,为提高HIV感染孕产妇及其新生儿健康质量提供参考依据。方法基于广西壮族自治区、云南省和新疆维吾尔自治区建立的HIV感染孕产妇及所生儿童母子队列(PMTCT-MC-2005),于2017年1月至2023年6月分娩的孕产妇为研究对象,纳入1646例孕产妇(HIV感染者和未感染者分别为558和1088例),剔除数据缺失者34例。分别采用χ^(2)检验分析两组研究对象不良妊娠结局发生率的差异,采用logisitc回归模型分析HIV感染孕产妇不良妊娠结局的影响因素。结果在研究对象1612例孕产妇中,HIV感染者和非感染者分别为541和1071例。不良妊娠结局发生率为18.8%(303/1612),其中HIV感染者和非感染者分别为33.1%(179/541)和11.6%(124/1071)。多因素logistic回归分析结果显示,分娩年龄<35岁组(相比于≥35岁组,a OR=0.64,95%CI:0.43~0.95)和抗病毒治疗时间≥10年(相比于<1年,a OR=0.43,95%CI:0.23~0.79)与不良妊娠结局的发生呈负相关。结论2017-2023年我国部分地区HIV感染孕产妇不良妊娠结局的发生率较高。HIV感染孕产妇应结合抗病毒治疗效果,科学安排其妊娠间隔时间,加强自我保健,减少不良妊娠结局的发生。Objective To understand the incidence of adverse pregnancy outcome in HIV-infected pregnant women and influencing factors in China and provide reference for the improvement of the health status of HIV-infected pregnant women and their newborns.MethodsBased on a mother-child cohort of HIV-infected pregnant women and children(PMTCT-MC-2005)established in Guangxi Zhuang Autonomous Region,Yunnan Province and Xinjiang Uygur Autonomous Region,this study enrolled pregnant women with or without HIV infection as study subjects from January 2017 to June 2023,a total of 1646 pregnant women(558 HIV-infected and 1088 HIV-uninfected)were included,and 34 cases with missing data were excluded.Theχ^(2) test was used to analyze the difference in the incidence adverse pregnancy outcome between two groups,and used logistic regression model to identify the influencing factors of adverse pregnancy outcome in HIV-infected pregnant women.ResultsA total of 1612 pregnant women were included in the study,in whom 541 were infected with HIV and 1071 were not infected with HIV.The incidence of adverse pregnancy outcome was 18.8%(303/1612),the incidence of adverse pregnancy outcome was 33.1%(179/541)in the HIV-infected pregnant women and 11.6%(124/1071)in the pregnant women without HIV infection.The results of multivariable logistic regression analysis showed that the influencing factors of adverse pregnancy outcome were age<35 years at delivery(a OR=0.64,95%CI:0.43-0.95)compared with the age≥35 years and the duration of antiviral treatment over 10 years(a OR=0.43,95%CI:0.23-0.79)compared with less than one year.Conclusions The incidence of adverse pregnancy outcome in HIV-infected pregnant women was high in some regions of China during 2017-2023.It is necessary for HIV-infected women to get pregnancy at appropriate time based on antiretroviral treatment effect and strengthen self-care to reduce the incidence of adverse pregnancy outcome.

关 键 词：艾滋病病毒 孕产妇 不良妊娠结局 影响因素 

分 类 号：R714.251[医药卫生—妇产科学]