Alcalde Encinas M M, Moreno Guillén S, Piñera Salmerón P, García Henarejos J A, García García J, Martínez Madrid O J
Servicio de Medicina Interna, Fundación Hospital de Cieza, Murcia.
Rev Clin Esp. 1999 Sep;199(9):569-72.
To determine the frequency of pregnancies among HIV-infected women in a sanitary area. To evaluate the proportion of women not receiving anti-retroviral treatment to decrease vertical transmission and the reasons why this treatment was not administered.
Point prevalence study performed on all women followed for 1997 at the HIV Infection Unit in a 360-bed hospital. The following variables were obtained: social class, civil status and place of residence, risk factors for HIV infection, obstetric antecedents (pregnancies, number of term pregnancies, living newborns) as well as prescription or not of anti-retroviral therapy during pregnancy.
Out of 85 women included in the study, 51 (60%) reported to have had a pregnancy and 17 of these (33%) had interrupted the pregnancy at some time. No significant differences were found between pregnancy or abortion and the analyzed socio-demographic variables or risk factors for HIV infection. Only 12% of women with a full length pregnancy received anti-retroviral therapy. Of women with term pregnancy who were not treated, most (63%) did not know they were infected before delivery and an additional 10% refused therapy. Forty-four percent of women with children continued with pregnancy despite knowing they were infected. Vertical transmission occurred in a 13% of cases in which no therapy was instituted and in no case in which zidovudine was administered during pregnancy.
The frequency of pregnancies among HIV-infected women is high in our area and a substantial number of women do not know they are infected. These data support the serological study to HIV in all pregnant women and the necessity of a higher level of information in order that the seropositive women be aware of the responsibility she takes when she decides to go on with her pregnancy.
确定某卫生区域内感染艾滋病毒妇女的怀孕频率。评估未接受抗逆转录病毒治疗以降低垂直传播的妇女比例及其未接受该治疗的原因。
对一家拥有360张床位医院的艾滋病毒感染科在1997年随访的所有妇女进行现况调查。获取了以下变量：社会阶层、婚姻状况和居住地点、艾滋病毒感染的危险因素、产科病史（怀孕情况、足月妊娠数、存活新生儿数）以及孕期是否接受抗逆转录病毒治疗。
纳入研究的85名妇女中，51名（60%）报告曾怀孕，其中17名（33%）在某个时候终止了妊娠。怀孕或流产与所分析的社会人口统计学变量或艾滋病毒感染危险因素之间未发现显著差异。只有12%的足月妊娠妇女接受了抗逆转录病毒治疗。在未接受治疗的足月妊娠妇女中，大多数（63%）在分娩前不知道自己已感染，另有10%拒绝治疗。44%有孩子的妇女尽管知道自己已感染仍继续妊娠。在未进行治疗的病例中，13%发生了垂直传播，而在孕期使用齐多夫定的病例中未发生垂直传播。
我们地区感染艾滋病毒妇女的怀孕频率较高，且相当多的妇女不知道自己已感染。这些数据支持对所有孕妇进行艾滋病毒血清学检测，并需要提高宣传水平，以使血清学阳性妇女意识到她们决定继续妊娠时所承担的责任。
