广西壮族自治区HIV感染孕产妇所生新生儿早产低出生体重发生情况及影响因素分析

Prevalence and associated factors of preterm birth and low birth weight in children from HIV-infected pregnant women in Guangxi Zhuang Autonomous region

目的了解广西壮族自治区HIV感染孕产妇所生新生儿早产、低出生体重发生情况及影响因素。方法以2015年1月至2020年12月广西分娩的HIV感染产妇及所生新生儿为研究对象,对母亲人口学特征、妊娠情况、抗病毒治疗和妊娠结局等情况进行统计,分析早产和低出生体重儿发生率及其相关影响因素。结果共纳入3164例HIV感染孕产妇及其所生新生儿信息,早产发生率为14.70%,低出生体重发生率为17.51%。孕前已确诊HIV感染(a OR=1.404,95%CI:1.095~1.801)、孕期随访次数少(a OR=1.469,95%CI:1.193~1.808)是发生早产的危险因素。文化程度高是分娩低出生体重儿的保护因素;经产妇(a OR=1.503,95%CI:1.220~1.851)、中重度贫血(a OR=1.879,95%CI:1.205~2.929)、妊娠期高血压疾病(a OR=2.457,95%CI:1.450~4.164)是导致新生儿低出生体重的危险因素。结论广西HIV感染孕产妇所生新生儿早产、低出生体重发生率较高,是常见的不良妊娠结局,且受HIV感染确诊时期、孕期随访次数,产次、妊娠并发症等因素影响,需要针对性的宣教和干预。

Objective To describe the prevalence of preterm birth and low birth weight in children from HIVinfected pregnant women and identify associated risk factors in the Guangxi Zhuang Autonomous region.Methods HIVinfected pregnant women and their children delivered in Guangxi from January 2015 to December 2020 were selected.The demographic characteristics of mothers,pregnancy status,antiretroviral therapy,pregnancy outcomes and the incidence of preterm birth and low birth weight and related influencing factors were analyzed.Results A total of 3164 HIV-infected pregnant women and their children were enrolled.The preterm birth rate was 14.70%,and the incidence of low birth weight was 17.51%.HIV infection before pregnancy(a OR=1.404,95%CI:1.095-1.801)and less times of follow-up during pregnancy(a OR=1.469,95%CI:1.193-1.808)were risk factors for preterm birth.High education level was a protective factor for low birth weight.Multiparous women(a OR=1.503,95%CI:1.220-1.851),moderate to severe anemia(a OR=1.879,95%CI:1.205-2.929)and hypertensive disorders during pregnancy(a OR=2.457,95%CI:1.450-4.164)were risk factors for low birth weight.Conclusions Preterm birth and low birth weight are common adverse pregnancy outcomes in HIV-infected pregnant women in Guangxi.Due to the influence of the HIV diagnosis period,pregnancy follow-up times,parity,pregnancy complications,and other factors,targeted education,intervention are needed.