HIV阳性孕妇所生子女低出生体重发生率及影响因素分析

Incidence and risk factors for low birth weight of infants born to HIV positive women

目的探讨感染艾滋病病毒(HIV)的孕妇所生子女低出生体重情况及其相关影响因素,为中国HIV母婴阻断工作提供参考。方法以2003年1月至2014年12月湖北、河北、山西部分县市及新疆伊宁市发现的HIV阳性孕妇及其子女为研究对象,收集相关资料进行卡方检验及Logistic回归分析,探讨其子女低出生体重的危险因素。结果纳入研究的608名子女中,低出生体重31人(5.10%)。多因素Logistic回归分析表明,子女低出生体重的危险因素包括:阻断方案中含有蛋白酶抑制剂(PI)[比值比(OR)=4.491,95%可信区间(CI):1.336~15.093]、子女HIV阳性(OR=4.652,95%CI:1.547~13.995)。结论应尽早发现HIV阳性孕妇并进行抗反转录病毒治疗,同时应警惕PI类药物对子女出生体重的影响,做好早期预防和管理,以降低低出生体重发生率。

Objective To investigate the characteristics of low birth weight infants born to human immunodeficiency virus（HIV） infected women and the associated factors to provide the reference for the prevention of HIV transmission from mother to child in China. Methods Information of HIV positive women and their infants from Hubei, Hebei, Shanxi provinces and Yining city of Xinjiang Uygur Autonomous Region were collected with a delivery date from Jan 2003 to Dec 2014. Chi-Square test and logistic regression were used to analyze the risk factors for infants＇ low birth weight. ResultsTotally, 608 infants were enrolled and 31 were low birth weight（5.10%）. Multi-factor logistic analysis showed that the risk factors of low birth weight consisted of regimen with protease inhibitor（PI）（OR 4.491, 95%CI 1.336-15.093） and infants＇ HIV infection（OR 4.652, 95%CI 1.547-13.995）. Conclusion HIV positive pregnant women should be detected and treated with antiretroviral therapy（ART） as early as possible. Attention should be paid to PI which affects infant＇s low birth weight. Early prophylactic measures and case management of HIV infected mothers should be taken to decrease the rate of low birth weight infants born to HIV positive mothers.