Martí Covadonga, Peña Jose M, Bates Isabel, Madero Rosario, de José Isabel, Pallardo Luis Felipe, Arribas Jose Ramón, Gonzalez-Garcia Juan, Gonzalez Antonio, Vazquez Juan José
Department of Gynecology and Obstetrics, Maternity Hospital, Madrid, Spain.
Acta Obstet Gynecol Scand. 2007;86(4):409-15. doi: 10.1080/00016340601148531.
The unquestionable benefit of antiretroviral therapy in reducing the rate of mother-to-child transmission can be lessened by potential maternal or neonatal toxicity.
To analyze obstetric and perinatal complications in a cohort of HIV-infected pregnant women and their relationship with maternal antiretroviral therapy.
One hundred and sixty-seven HIV-infected pregnant women who delivered at Hospital Universitario La Paz, Madrid, Spain between January 1997 and December 2003.
Data on the clinical and epidemiological characteristics of HIV-infected patients, previous and current antiretroviral therapy, gestational diabetes mellitus, length of pregnancy, mode of delivery, and weight of the newborn were collected. Pregnancy outcomes were compared with those of all the pregnant women attended at our hospital.
Gestational diabetes mellitus, premature delivery, and low birth weight.
Gestational diabetes mellitus was diagnosed in 8.9% of patients. All the cases of gestational diabetes were in the combined antiretroviral therapy group, and the majority were receiving triple antiretroviral therapy with a protease inhibitor. The risk of developing this pathology was greater among women receiving antiretroviral therapy prior to pregnancy. The premature delivery rate was 29% and the low birth weight rate was 28%.
Gestational diabetes mellitus is more common in HIV-infected women than in the general population and is related to combined antiretroviral therapy, especially the use of protease inhibitors, which suggests the need for close follow-up during pregnancy in HIV-infected patients. Nevertheless, the adverse perinatal consequences observed were more related to maternal factors than to antiretroviral therapy.
抗逆转录病毒疗法在降低母婴传播率方面的显著益处可能会因潜在的母体或新生儿毒性而减弱。
分析一组感染艾滋病毒的孕妇的产科和围产期并发症及其与母体抗逆转录病毒疗法的关系。
1997年1月至2003年12月期间在西班牙马德里拉巴斯大学医院分娩的167名感染艾滋病毒的孕妇。
收集了感染艾滋病毒患者的临床和流行病学特征、既往和当前的抗逆转录病毒疗法、妊娠期糖尿病、妊娠时长、分娩方式和新生儿体重等数据。将妊娠结局与我院所有就诊孕妇的结局进行比较。
妊娠期糖尿病、早产和低出生体重。
8.9%的患者被诊断为妊娠期糖尿病。所有妊娠期糖尿病病例均在联合抗逆转录病毒疗法组，且大多数患者正在接受含蛋白酶抑制剂的三联抗逆转录病毒疗法。妊娠前接受抗逆转录病毒疗法的女性患这种疾病的风险更高。早产率为29%，低出生体重率为28%。
感染艾滋病毒的女性患妊娠期糖尿病比普通人群更常见，且与联合抗逆转录病毒疗法有关，尤其是蛋白酶抑制剂的使用，这表明感染艾滋病毒的患者在孕期需要密切随访。然而，观察到的不良围产期后果更多与母体因素有关，而非抗逆转录病毒疗法。
