人类免疫缺陷病毒感染对妊娠结局的影响

Effects of human immunodeficiency virus infection on pregnancy outcome

目的 探讨人类免疫缺陷病毒 (HIV)感染对妊娠结局的影响及母婴垂直传播的发生情况。方法 应用酶联免疫吸附试验对 2 678例孕妇及其婴幼儿的外周血HIV抗体进行检测 ,其中资料完整的 86例HIV抗体阳性孕妇为HIV组 ,另选择与HIV组年龄、孕周相匹配的HIV抗体检测阴性的4 0例健康孕妇及其婴幼儿作为对照组。采用回顾性分析的方法 ,对两组孕妇的妊娠结局进行跟踪随访。结果 ( 1)HIV组孕妇中 ,流产、早产、低体重儿及小于胎龄儿的发生率分别为 9 3 % ( 8 86)、14 0 % ( 12 86)、16 3 % ( 14 86)及 10 5 % ( 9 86) ,明显高于对照组的 2 5 % ( 1 4 0 )、5 0 % ( 2 4 0 )、7 5 % ( 3 4 0 )及 2 5 % ( 1 4 0 )。两组比较 ,差异有显著性 (P <0 0 5 )。( 2 )HIV组孕妇中 ,合并念珠菌性阴道炎及尖锐湿疣的发生率分别为 9 3 %与 8 1% ,明显高于对照组的 2 5 %及 2 5 % ,两组比较 ,差异有显著性(P <0 0 5 )。( 3 )HIV组孕妇中 ,母婴HIV垂直传播发生率为 12 8% ,而对照组孕妇所分娩的婴儿中 ,HIV抗体检测均为阴性 ,发生率为 0 %。两组孕妇HIV感染垂直传播率比较 ,差异有极显著性 (P<0 0 1)。结论 孕妇感染HIV后可显著增加流产、早产、低体重儿及小于胎龄儿等不良妊娠结局的发生率 。

Objective To investigate the effects of human immunodeficiency virus (HIV) infection on the pregnancy outcome and the incidence of vertical transmission in HIV positive pregnant women Method 86 cases of HIV positive pregnant women and their infants were evaluated retrospectively, and HIV antibody in peripherial blood was detected using enzyme linked immunosorbent assay (ELISA) Results Compared with normal control group, the incidences of abortion, preterm birth, low birth weight and small for gestational age babies were 9 3%, 14 0%, 16 3% and 10 5%, respectively ( P <0 05); the occurrence of conditional infections of reproductive tract was also higher ( P <0 05); and the incidence of vertical transmission was 12 8% ( P <0 01) Conclusions HIV infection in pregnant women markedly increases the risks of abortion, preterm birth, low birth weight and small for gestational age babies, and elevates the incidence of conditional infections of reproductive tract The incidence of vertical transmission was 12 8% These data support that it is very important to provide prenatal care to HIV infected pregnant women and prevent pregnant women from HIV infection