中华医学杂志（英文版）2012，Vol.125Issue(3)：403-409,7.DOI:10.3760/cma.j.issn.0366-6999.2012.03.001
Pregnancy outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women in Guangxi, China
Pregnancy outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women in Guangxi, China
YU Lan 1LI Wen-ying 2Ray Y. Chen 3TANG Zhi-rong 4PANG Jun 5GUI Xiu-zhi 6MENG Xiu-ning 7ZHANG Fu-jie8
作者信息
- 1. Centers for Disease Control and Prevention, Beijing 100050, China
- 2. Global AIDS Program Beijing Office, USCDC, Beijing 100000,China
- 3. Institutes of Health
- 4. based at the U.S. Embassy Beijing, Beijing 100000, China
- 5. Outpatient Clinic, Provincial Center of Diseases Control and Prevention, Nanning, Guangxi 530000, China
- 6. Department of Obstetrics and Gynecology, No. 4 Infectious Disease Hospital of Nanning, Nanning, Guangxi 530000, China
- 7. Matemal and Child Care Service Hospital of Liuzhou, Liuzhou,Guangxi 545001, China
- 8. Maternal and Child Care Service Hospital of Hengxian, Hengxian,Guangxi 530300, China
- 折叠
摘要
Abstract
Background Six provinces in China accounted for 70％-80％ of all reported HIV/AIDS cases in the country in 2009 and five provinces accounted for 78％ of all reported mother-to-child transmission (MTCT) of HIV cases.Because Guangxi belonged to both groups,the Prevention of Mother-to-Child Transmission (PMTCT) Plus program was established there to understand better low birth weight (LBW) and preterm delivery (PD) birth outcomes and their associated risk factors better.Methods Pregnancy outcomes were examined among HIV-infected pregnant women who enrolled in the PMTCT Plus program from June 2006 to February 2009 in Guangxi,China.Multivariate Logistic regression analysis was used to explore the risk factors associated with LBW (＜2500 g) and PD (gestational age ＜37 weeks).Results The prevalence of LBW and PD among 194 HIV-positive mothers was 19.6％ (38/194) and 9.8％ (19/194),respectively.Multivariate Logistic regression analysis showed that CD4 cell count ＜100 cell/μI (multivariate-adjusted odds ratio (AOR) 5.52; 95％ CI 1.11-25.55) and CD4 cell count 100-199 cells/μl (AOR 3.40; 95％ Cl 1.03-11.25,compared to CD4 cell count ≥350 cells/μl),gestational age ＜37 weeks (AOR 4.38; 95％ CI 1.29-14.82,compared to ≥37 weeks),maternal weight ＜45 kg (AOR 5.64; 95％ Cl 1.09-29.07) and maternal weight 45-54 kg (AOR 3.55; 95％ Cl 1.31-9.60,compared to ≥55 kg) at enrollment,and HIV RNA ≥100 000 copies/ml at enrollment (AOR 4.22; 95％ Cl 1.24-14.32) and 20 000-99 999 (AOR 2.77; 95％ CI 1.01-7.77,compared to ＜20 000 copies/ml) were associated with a higher risk of LBW.For PD,only maternal injection drug use as the route of HIV transmission (AOR 5.30; 95％ CI 1.33-21.14,compared to those infected with HIV through sexual transmission) was significantly associated with a higher risk of PD.Conclusions Lower CD4 cell count and higher HIV RNA viral load at enrollment were associated with LBW.Optimal antenatal care,including earlier antenatal screening and HIV diagnosis,is critical to earlier PMTCT prophylaxis and/or HIV treatent to prevent transmission of HIV to the infant and also to prevent LBW pregnancy outcomes.关键词
pregnancy outcome/low birth weight/preterm delivery/HIV, pregnant womenKey words
pregnancy outcome/low birth weight/preterm delivery/HIV, pregnant women引用本文复制引用
YU Lan,LI Wen-ying,Ray Y. Chen,TANG Zhi-rong,PANG Jun,GUI Xiu-zhi,MENG Xiu-ning,ZHANG Fu-jie..Pregnancy outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women in Guangxi, China[J].中华医学杂志（英文版）,2012,125(3):403-409,7.
