Bansil Pooja, Jamieson Denise J, Posner Samuel F, Kourtis Athena P
CONRAD Program, Arlington, Virginia, USA.
J Womens Health (Larchmt). 2007 Mar;16(2):159-62. doi: 10.1089/jwh.2006.CDC2.
Highly active antiretroviral therapy (HAART) has improved the outlook of HIV-infected patients, but it has several side effects, particularly when it is used during pregnancy. Prior to the advent of HAART, HIV-infected women were at increased risk for adverse pregnancy outcomes. This report describes hospital use among pregnant HIV-infected women in the United States in the HAART era and compares hospitalizations for select morbidities in pregnant HIV-infected vs. uninfected women. In 2003, the majority of HIV-infected pregnant women were hospitalized in urban hospitals in the South and had Medicare or Medicaid as the expected payer. HIV-infected pregnant women had longer hospitalizations and incurred higher hospitalization charges than uninfected women. In addition, HIV-infected pregnant women were more likely to be hospitalized for major puerperal sepsis, sexually transmitted infections, urinary tract infections, bacterial infections, liver disorders, and preterm labor/delivery than uninfected women, even after adjusting for sociodemographic factors and comorbid conditions. No significant differences were observed in the rates of preeclampsia and antepartum hemorrhage in the two groups. HIV-infected pregnant women in the United States in the era of HAART remain at higher risk for several morbidities and adverse obstetrical outcomes than uninfected women.
高效抗逆转录病毒疗法(HAART)改善了HIV感染患者的预后,但它有多种副作用,尤其是在孕期使用时。在HAART出现之前,HIV感染的女性出现不良妊娠结局的风险更高。本报告描述了HAART时代美国HIV感染孕妇的住院情况,并比较了HIV感染孕妇与未感染孕妇因特定疾病的住院情况。2003年,大多数HIV感染的孕妇在南方的城市医院住院,预计支付方为医疗保险或医疗补助。与未感染的女性相比,HIV感染的孕妇住院时间更长,住院费用更高。此外,即使在调整了社会人口因素和合并症之后,与未感染的女性相比,HIV感染的孕妇因严重产褥期败血症、性传播感染、尿路感染、细菌感染、肝脏疾病以及早产/分娩而住院的可能性更高。两组子痫前期和产前出血的发生率没有显著差异。在HAART时代,美国HIV感染的孕妇比未感染的女性在多种疾病和不良产科结局方面的风险仍然更高。