高效抗逆转录病毒治疗HIV感染女性围产期及妊娠结局分析

Perinatal and pregnancy outcomes of women infected with HIV treated with long-term highly active antiretroviral therapy

目的了解经高效抗逆转录病毒治疗HIV产妇围产期合并症、并发症及预后情况。方法收集2016年1月-2020年1月合浦县人民医院(69例)、广西壮族自治区妇幼保健院妇产科(36例)收治的105例经高效抗逆转录病毒治疗≥1年HIV孕妇的临床基本资料,另外随机选择同时期两家医院(合浦县人民医院70例,广西壮族自治区妇幼保健院35例)排除HIV感染并住院分娩的105例适龄产妇为对照组,比较两组产妇围产期产科并发症、合并症和妊娠结局情况,并进行分析。结果 HIV产妇贫血29例(占27.6%)、妊娠期高血压33例(占31.4%)、宫内死胎10例(占9.5%)、羊水过多23例(占21.9%)、胎膜早破17例(占16.2%)、产后出血20例(占19.0%)、胎盘早剥15例(占14.3%),均显著高于正常产妇(P<0.05);新生儿体质重(3 313.18±216.14)g显著低于正常产妇(3 395.88±195.45)g(P<0.05);HIV产妇新生儿早产发生15例(占14.3%)、胎儿窘迫16例(占15.2%)、胎位不正16例(占15.2%)、羊水粪染发生23例(占21.9%)及Apgar<5分病例数16例(占15.2%)、新生儿ICU住院22例(占21.0%)、新生儿肺炎发生17例(占16.2%)显著高于正常产妇(P<0.05)。结论经长期高效抗逆转录病毒治疗HIV产妇围产期并发症和合并症多,新生儿低体重及并发症多,但可能有助于改善HIV产妇新生儿死亡率。

Objective To investigate the perinatal complications,complications and prognosis of HIV parturient women treated with long-term high efficiency antiretroviral therapy.Methods We collected clinical basic information of 105 cases of long-term effective antiretroviral therapy(ART)>1 year of maternal HIV,in Department of Obstetrics,Guangxi Zhuang Autonomous Region Hepu County People's Hospital(69 cases)and Department of Obstetrics,Guangxi Maternal and Child Health Hospital(36 cases)treated in January 2016-January 2020,and randomly selected 105 cases of exclude HIV infections and childbirth age pregnant women in the two hospitals(70 cases and 35 cases)at the same time as control group,compared and analyzed two groups of perinatal maternal obstetric complications,complications,and pregnancy outcomes.Results The rates of anemia(29 cases,27.6%),gestational hypertension(33,31.4%),intrauterine stillbirth(10,9.5%),polyhydramnios (23,21.9%),premature rupture of membranes(17,16.2%),postpartum hemorrhage(20,19.0%)and placental abruption(15,14.3%)in HIV parturient women were significantly higher than those in normal parturient women(P<0.05).The weight of newborn(3313.18±216.14)g in HIV parturient women was significantly lower than that of normal parous(3395.88±195.45)g(P<0.05);incidence of preterm birth(15,14.3%),fetal distress(16,15.2%),malposition(16,15.2%),the incidence rate of amniotic fluid dung dye(23,21.9%)and Apgar<5 points(16,15.2%),neonatal ICU hospitalization rates(22,21.0%),the incidence of neonatal pneumonia(17,16.2%)in HIV parturient women were significantly higher than that in normal women(P<0.05).Conclusion HIV patients treated with long-term high performance antiretroviral therapy have more perinatal complications and complications,lower birth weight and more complications,but contribute to improve neonatal mortality.