广东省HIV感染母亲所生新生儿低出生体重的影响因素分析

Influencing factors on low birth weight among newborns born to HIV-infected mothers in Guangdong province

目的分析广东省艾滋病病毒(HIV)感染母亲所生新生儿,发生低出生体重的影响因素。方法提取2007年1月至2015年6月,广东省免费预防艾滋病母婴传播项目登记的1 365例HIV感染母亲及其所生活产新生儿的个案调查数据,采用多因素Logistic回归分析。结果HIV感染母亲所生的1 365名新生儿中,13.11%(179人)的出生体重<2 500g(低出生体重),1.03%(14例)的出生体重<1 500g(极低出生体重)。这些新生儿低出生体重的高危因素有母亲年龄较大[矫正比值比(aOR)=1.05,95%可信区间(CI):1.02~1.08]、流动人口[市内各县区间流动(aOR=1.77,95%CI:1.14~2.75)、省内各市间流动(aOR=2.52,95%CI:1.41~4.48)]、注射吸毒感染HIV(aOR=2.53,95%CI:1.09~5.91)、围产期发生并发症(aOR=2.52,95%CI:1.68~3.79)、孕期服用抗艾滋病病毒药物(aOR=1.84,95%CI:1.24~2.71)、早产[28-32周(aOR=58.01,95%CI:7.07~476.04),33-36周(aOR=4.64,95%CI:2.34~9.21)]、以及女性新生儿(aOR=1.72,95%CI:1.18~2.51)。结论 HIV感染母亲所生新生儿低出生体重的发生受母亲社会经济特征、围产期高危因素和新生儿性别等多因素影响,需要综合评估和干预。

Objective To explore the influencing factors on low birth weight among newborns horn to HIV-in- fected mothers in Guangdong province. Methods The data of 1365 HIV-infected mothers and their live newborns were derived from registered cases in the program of prevention from mother-to-children transmission in Guangdong from January 2007 to June 2015, and the multivariate logistic regression model was used for the analysis. Results Among 1365 newborns born to HIV-infeeted mothers, 13.11% （179） were LBW （birth weight less than 2 500g）, and 1.03% （14） were very low birth weight （birth weight less than 1500g）. The risk factors of low birth weight a- mong these newborns included greater maternal age（OR = 1.05, 95 % CI： 1.02-1.08）, floating population between districts in city（OR= 1.77,95%CI：1.14-2.75） and between cities in province（OR= 2.52, 95%CI：1.41-4.48）1, HIV-infected by drug injection（OR=2.53,95%CI：1.09-5.91）, perinatal period complication（OR= 2.52, 95%CI： 1.68-3.79）, use ARVs during pregnancy of mother（OR= 1.84, 95%CI： 1.24-2.71）, preterm birth 28-32 weeks （OR=58.01, 95%CI： 7.07-478.04）, 33-36 weeks（OR=4.64, 95 %CI： 2.34-9.21） and female newborns（OR= 1.72, 95%CI：1.18-2. 51）. Conclusion The low birth weight of newborns born to HIV-infected mothers is influ- enced by multi-factors including maternal socioeconomic status, and high risk factors during perinatal period and gender of newborns, which should have integrated prevention measures.