感染人类免疫缺陷病毒的孕产妇及其母婴传播的情况分析

Analysis of cases of pregnant women infected with HIV and their mother-to-child transmission

目的:研究近年来人类免疫缺陷病毒感染的孕产妇及母婴传播的有关情况。方法:对2013-2018年在武汉大学中南医院分娩及作者参与诊治感染人类免疫缺陷病毒的孕产妇及出生的婴儿,通过查询及随访系统,收集整理相关的临床资料及信息。结果:175例人类免疫缺陷病毒感染的孕产妇,分娩时年龄为(29.6±6.5)岁,≤20岁的9人,21~34岁的137人,≥35岁的24人。孕妇感染的途径:性传播161人,占92.00%,不安全输血8例,母婴传播4例,静脉吸毒2例。分娩年份:2013-2014年42例占23.99%,2015-2016年68例占38.86%,2017-2018年65例占37.15%。分娩胎次:系头胎108人占61.71%,≥二胎的67人占38.29%。妊娠结局及分娩方式:终止妊娠47例,117例完成分娩,其中剖宫产106例占90.60%,阴道分娩11例占9.40%。丈夫或配偶HIV感染状况:感染阳性48例占31.37%,阴性105例,占68.63%,情况不明的22例。母亲孕期服用阻断药物81人中,母婴传播1例,母婴传播率为1.23%。未服用阻断药物27人,母婴传播10例,母婴传播率为37.04%。结论:近年来未达婚龄及高龄孕妇感染不容忽视,二胎政策放开后,孕产妇感染及母婴传播的疫情更为严峻,综合防治任重道远。

Objective:To study the situation of maternal women and mother-to-child transmission of human immunodeficiency virus infection(HIV)in recent years.Methods:From 2013 to 2018,relevant clinical data and information were collected through the inquiry and follow-up system for maternal women dignosed with HIV infection and infants in wuhan university Zhongnan hospital.Results:Among the175 women infected with HIV,the age of delivery was(29.6±6.5),9 cases were≤20 years old,137 cases were between 21 and 34 years old,and 24 cases were≥35 years old.Methods of infection in pregnant women were 161 cases of sexual transmission,accounting for 92.00%,8 cases of unsafe blood transfusion,4 cases of mother-to-child transmission,and 2 cases of intravenous drug abuse.Year of delivery included 42 cases in 2013-2014,accounting for 23.99%,68 cases in 2015-2016,accounting for 38.86%,and 65 cases in 2017-2018,accounting for 37.15%.Birth time showed 108 cases of first-born babies,accounting for 61.71%,67 cases of≥second born babies,accounting for38.29%.Pregnancy outcome and delivery mode were 47 cases of terminated pregnancy,117 cases of completed delivery.Among which,106 cases were cesarean section,accounting for 90.60%,and 11 cases of vaginal delivery,accounting for 9.40%.HIV infection status of husband or spouse was 48 cases of positive HIV infection,accounting for 31.37%,105 cases with negative HIV antibody,accounting for 68.63%,and 22 cases of unknown.Among the 81 mothers who took blocking drugs during pregnancy,mother-to-child transmission occurred in 1 case,with a mother-to-child transmission rate of 1.23%.There were 10 cases of mother-to-child transmission among 27 patients who did not take blocking drugs,and the mother-to-child transmission rate was 37.04%.Conclusion:In recent years,the HIV infection of pregnant women who have not reached the age of marriage or who are very old cannot be ignored.After the implementation of the two-child policy,the epidemic situation of maternal infection and mother-to-child transmission has become more severe.