Townsend C L, Cortina-Borja M, Peckham C S, Tookey P A
MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK.
BJOG. 2008 Aug;115(9):1078-86. doi: 10.1111/j.1471-0528.2008.01706.x. Epub 2008 May 22.
To describe the changing demographic profile of diagnosed HIV-infected pregnant women over time and trends in pregnancy outcome, uptake of interventions and mother-to-child transmission.
National surveillance study.
UK and Ireland.
Diagnosed HIV-infected pregnant women, 1990-2006.
Active surveillance of obstetric and paediatric HIV conducted through the National Study of HIV in Pregnancy and Childhood.
Maternal characteristics, pregnancy outcome, use of antiretroviral therapy, mode of delivery and mother-to-child transmission.
A total of 8327 pregnancies were reported, increasing from 82 in 1990 to 1394 in 2006, with an increasing proportion from areas outside London. Injecting drug use as the reported risk factor for maternal HIV acquisition declined from 49.2% (185/376) in 1990-1993 to 3.1% (125/4009) in 2004-2006 (P < 0.001), while the proportion of women born in sub-Saharan Africa increased from 43.5% (93/214) in 1990-1993 to 78.6% (3076/3912) in 2004-2006 (P < 0.004). Reported pregnancy terminations decreased from 29.6% (111/376) in 1990-1993 to 3.4% (135/4009) in 2004-2006 (P < 0.001). Most (56.4%, 3717/6593) deliveries were by elective caesarean section, with rates highest in 1999 (66.4%, 144/217). Vaginal deliveries increased from 16.6% (36/217) in 1999 to 28.3% (321/1136) in 2006 (P < 0.001). Use of antiretroviral therapy in pregnancy increased over time, reaching 98.4% (1092/1110) in 2006, and the overall mother-to-child transmission rate declined from 18.5% (35/189) in 1990-1993 to 1.0% (29/2832) in 2004-2006.
The annual number of reported pregnancies increased dramatically between 1990 and 2006, with changing demographic and geographic profiles and substantial changes in pregnancy management and outcome.
描述确诊感染艾滋病毒的孕妇的人口统计学特征随时间的变化情况以及妊娠结局、干预措施的采用情况和母婴传播的趋势。
全国性监测研究。
英国和爱尔兰。
1990年至2006年确诊感染艾滋病毒的孕妇。
通过全国孕期和儿童期艾滋病毒研究对产科和儿科艾滋病毒进行主动监测。
产妇特征、妊娠结局、抗逆转录病毒疗法的使用情况、分娩方式和母婴传播。
共报告了8327例妊娠，从1990年的82例增加到2006年的1394例，来自伦敦以外地区的比例不断增加。报告的产妇感染艾滋病毒的危险因素中，注射吸毒从1990 - 1993年的49.2%（185/376）降至2004 - 2006年的3.1%（125/4009）（P < 0.001），而撒哈拉以南非洲出生的女性比例从1990 - 1993年的43.5%（93/214）增至2004 - 2006年的78.6%（3076/3912）（P < 0.004）。报告的妊娠终止率从1990 - 1993年的29.6%（111/376）降至2004 - 2006年的3.4%（135/4009）（P < 0.001）。大多数（56.4%，3717/6593）分娩通过择期剖宫产进行，1999年的比例最高（66.4%，144/217）。阴道分娩从1999年的16.6%（36/217）增至2006年的28.3%（321/1136）（P < 0.001）。孕期抗逆转录病毒疗法的使用随时间增加，2006年达到98.4%（1092/1110），总体母婴传播率从1990 - 1993年的18.5%（35/189）降至2004 - 2006年的1.0%（29/2832）。
1990年至2006年间报告的年度妊娠数大幅增加，人口统计学和地理特征发生变化，妊娠管理和结局也有重大改变。
