Cavasin Helen, Dola Thao, Uribe Olga, Biswas Manoj, Do Mai, Bhuiyan Azad, Dery MarkAlain, Dola Chi
Tulane Health Sciences Center, Tulane University School of Medicine, LA 70112, USA.
Infect Dis Obstet Gynecol. 2009;2009:827405. doi: 10.1155/2009/827405. Epub 2009 May 25.
To compare the infectious complication rates from cesarean delivery of human immunodeficiency virus (HIV)-infected women and HIV-negative women.
A retrospective analysis was performed on data derived from HIV-infected women and HIV-negative women, who underwent cesarean delivery at two teaching hospitals. Main outcome measures were infectious postoperative morbidity. Descriptive, comparison analysis, and multiple logistic regression analysis were performed.
One hundred and nineteen HIV-infected women and 264 HIV-negative women delivered by cesarean section and were compared. The HIV-negative women were more likely than the HIV-infected women to deliver by emergent cesarean section (78.0% versus 51.3%, resp., P < .05), to labor prior to delivery (69.4% versus 48.3%, resp., P < .01), and to have ruptured membranes prior to delivery (63.5% versus 34.8%, resp., P < .05). In bivariate analysis, HIV-infected and HIV-negative women had similar rates of post-operative infectious complications (16.8% versus 19.7%, resp., P > .05). In a multivariate stepwise logistic analysis, emergent cesarean delivery and chorioamnionitis but not HIV infection were associated with increased rate of post-operative endometritis (odds ratio (OR) 4.10, 95% confidence interval (95% CI) 1.41-11.91, P < .01, and OR 3.02, 95% CI 1.13-8.03, P < .05, resp.).
In our facilities, emergent cesarean delivery and chorioamnionitis but not HIV infection were identified as risk factors for post-operative endometritis.
比较人类免疫缺陷病毒(HIV)感染女性与HIV阴性女性剖宫产术后感染并发症的发生率。
对两家教学医院接受剖宫产的HIV感染女性和HIV阴性女性的数据进行回顾性分析。主要观察指标为术后感染性发病率。进行描述性分析、比较分析和多因素logistic回归分析。
119例HIV感染女性和264例HIV阴性女性接受了剖宫产并进行比较。HIV阴性女性比HIV感染女性更有可能进行急诊剖宫产(分别为78.0%对51.3%,P<.05)、分娩前有产程(分别为69.4%对48.3%,P<.01)以及分娩前胎膜破裂(分别为63.5%对34.8%,P<.05)。在双变量分析中,HIV感染女性和HIV阴性女性术后感染并发症发生率相似(分别为16.8%对19.7%,P>.05)。在多因素逐步logistic分析中,急诊剖宫产和绒毛膜羊膜炎而非HIV感染与术后子宫内膜炎发生率增加相关(优势比(OR)4.10,95%置信区间(95%CI)1.41 - 11.91,P<.01;OR 3.02,95%CI 1.13 - 8.03,P<.05)。
在我们的医疗机构中,急诊剖宫产和绒毛膜羊膜炎而非HIV感染被确定为术后子宫内膜炎的危险因素。