Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between Octob...Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou, China. The women were assigned to receive combination ART(c ART) or mono/dual ART or no treatment. The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth, small for gestational age(SGA)] and adverse early growth outcome(including infant death, HIV infection of mother-to-child transmission, and underweight, wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202(35.1%) of all enrolled HIV-infected women, and121(31.3%) of all infants exhibited adverse effects on early growth at 4 weeks of age. The rates of adverse pregnancy outcomes, spontaneous abortion, ectopic pregnancy, stillbirth, infant death and perinatal HIV infection were higher among women not receiving ART, compared to those treated with c ART or mono/dual ART(P < 0.05). However, women treated with c ART had a higher rate of SGA,compared to untreated women(P < 0.05). No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART, as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival.展开更多
目的:研究宫腔外取胎头在瘢痕子宫剖宫产术中的应用效果。方法:通过回顾性分析的方式,选取2018年10月-2020年10月在东莞市第八人民医院进行剖宫产术的瘢痕子宫产妇作为研究对象,根据手术方法将其分为对照组与观察组,对照组40例行传统手...目的:研究宫腔外取胎头在瘢痕子宫剖宫产术中的应用效果。方法:通过回顾性分析的方式,选取2018年10月-2020年10月在东莞市第八人民医院进行剖宫产术的瘢痕子宫产妇作为研究对象,根据手术方法将其分为对照组与观察组,对照组40例行传统手入宫腔取胎头,观察组40例行宫腔外取胎头。对比分析两组新生儿出生后1、10 min的Apgar评分,以及取胎头时间、术中出血量、子宫切口撕裂率、切口愈合不良率、新生儿窒息和感染发生率、产后并发症发生率(切口血肿、切口感染、盆腔粘连、产后出血、产褥感染)。结果:观察组新生儿出生后1、10 min Apgar评分明显高于对照组,差异有统计学意义(P<0.05)。观察组的取胎头时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组的子宫切口撕裂率、切口愈合不良率、新生儿窒息和感染发生率均低于对照组,差异有统计学意义(P<0.05)。观察组的产后并发症发生率为7.50%,低于对照组的37.50%,差异有统计学意义(P<0.05)。结论:在瘢痕子宫剖宫产术中实施宫腔外取胎头的方式,能缩短取胎头时间,减少术中出血量,避免切口撕裂和愈合不良,一定程度上可以降低新生儿窒息情况,减少产妇产后并发症发生风险,提高新生儿的Apgar评分,应用效果理想。展开更多
基金Transmission of HIV·Chinese Association of STD and AIDS Prevention and Control [PMTCT2018-001]National Center for Women and Children’s Health,China,CDC(He Sheng Yuan Maternal and Infant’s Nutrition and Health Program)[2018FYH008]the National Natural Science Foundation of China [81673245,81673232]
文摘Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou, China. The women were assigned to receive combination ART(c ART) or mono/dual ART or no treatment. The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth, small for gestational age(SGA)] and adverse early growth outcome(including infant death, HIV infection of mother-to-child transmission, and underweight, wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202(35.1%) of all enrolled HIV-infected women, and121(31.3%) of all infants exhibited adverse effects on early growth at 4 weeks of age. The rates of adverse pregnancy outcomes, spontaneous abortion, ectopic pregnancy, stillbirth, infant death and perinatal HIV infection were higher among women not receiving ART, compared to those treated with c ART or mono/dual ART(P < 0.05). However, women treated with c ART had a higher rate of SGA,compared to untreated women(P < 0.05). No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART, as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival.
文摘目的:研究宫腔外取胎头在瘢痕子宫剖宫产术中的应用效果。方法:通过回顾性分析的方式,选取2018年10月-2020年10月在东莞市第八人民医院进行剖宫产术的瘢痕子宫产妇作为研究对象,根据手术方法将其分为对照组与观察组,对照组40例行传统手入宫腔取胎头,观察组40例行宫腔外取胎头。对比分析两组新生儿出生后1、10 min的Apgar评分,以及取胎头时间、术中出血量、子宫切口撕裂率、切口愈合不良率、新生儿窒息和感染发生率、产后并发症发生率(切口血肿、切口感染、盆腔粘连、产后出血、产褥感染)。结果:观察组新生儿出生后1、10 min Apgar评分明显高于对照组,差异有统计学意义(P<0.05)。观察组的取胎头时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组的子宫切口撕裂率、切口愈合不良率、新生儿窒息和感染发生率均低于对照组,差异有统计学意义(P<0.05)。观察组的产后并发症发生率为7.50%,低于对照组的37.50%,差异有统计学意义(P<0.05)。结论:在瘢痕子宫剖宫产术中实施宫腔外取胎头的方式,能缩短取胎头时间,减少术中出血量,避免切口撕裂和愈合不良,一定程度上可以降低新生儿窒息情况,减少产妇产后并发症发生风险,提高新生儿的Apgar评分,应用效果理想。
