Department of Paediatrics of the University Teaching Hospital and the University of Zambia School of Medicine, and the Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
BMC Pediatr. 2009 Aug 7;9:49. doi: 10.1186/1471-2431-9-49.
Reference values for hematological and biochemical assays in pregnant women and in newborn infants are based primarily on Caucasian populations. Normative data are limited for populations in sub-Saharan Africa, especially comparing women with and without HIV infection, and comparing infants with and without HIV infection or HIV exposure.
We determined HIV status and selected hematological and biochemical measurements in women at 20-24 weeks and at 36 weeks gestation, and in infants at birth and 4-6 weeks of age. All were recruited within a randomized clinical trial of antibiotics to prevent chorioamnionitis-associated mother-to-child transmission of HIV (HPTN024). We report nearly complete laboratory data on 2,292 HIV-infected and 367 HIV-uninfected pregnant African women who were representative of the public clinics from which the women were recruited. Nearly all the HIV-infected mothers received nevirapine prophylaxis at the time of labor, as did their infants after birth (always within 72 hours of birth, but typically within just a few hours at the four study sites in Malawi (2 sites), Tanzania, and Zambia.
HIV-infected pregnant women had lower red blood cell counts, hemoglobin, hematocrit, and white blood cell counts than HIV-uninfected women. Platelet and monocyte counts were higher among HIV-infected women at both time points. At the 4-6-week visit, HIV-infected infants had lower hemoglobin, hematocrit and white blood cell counts than uninfected infants. Platelet counts were lower in HIV-infected infants than HIV-uninfected infants, both at birth and at 4-6 weeks of age. At 4-6 weeks, HIV-infected infants had higher alanine aminotransferase measures than uninfected infants.
Normative data in pregnant African women and their newborn infants are needed to guide the large-scale HIV care and treatment programs being scaled up throughout the continent. These laboratory measures will help interpret clinical data and assist in patient monitoring in a sub-Saharan Africa context.
孕妇和新生儿血液生化分析的参考值主要基于白种人群。在撒哈拉以南非洲地区，关于该人群的规范数据有限，特别是在比较 HIV 感染者和未感染者，以及比较 HIV 感染或暴露婴儿和未感染者时。
我们在妊娠 20-24 周和 36 周时确定了 HIV 状态并选择了血液学和生化测量值，在出生时和 4-6 周龄时也测量了这些值。所有这些都是在预防绒毛膜羊膜炎相关母婴传播 HIV（HPTN024）的抗生素随机临床试验中招募的。我们报告了近 2292 名 HIV 感染和 367 名 HIV 未感染的妊娠非洲妇女的实验室数据，这些妇女来自公共诊所，具有代表性。几乎所有接受抗逆转录病毒药物预防的 HIV 感染母亲在分娩时都接受了奈韦拉平预防，其婴儿在出生后也接受了奈韦拉平预防（总是在出生后 72 小时内，但是在马拉维（2 个地点）、坦桑尼亚和赞比亚的 4 个研究地点通常在出生后仅数小时内）。
与 HIV 未感染的妇女相比，HIV 感染的孕妇的红细胞计数、血红蛋白、血细胞比容和白细胞计数较低。在两个时间点，HIV 感染的孕妇的血小板和单核细胞计数较高。在 4-6 周的就诊时，与未感染的婴儿相比，HIV 感染的婴儿的血红蛋白、血细胞比容和白细胞计数较低。与未感染的婴儿相比，HIV 感染的婴儿在出生时和 4-6 周时的血小板计数均较低。在 4-6 周时，与未感染的婴儿相比，HIV 感染的婴儿的丙氨酸氨基转移酶测量值较高。
需要为非洲孕妇及其新生儿制定规范数据，以指导整个非洲大陆正在扩大的大规模 HIV 护理和治疗计划。这些实验室指标将有助于解释临床数据，并协助撒哈拉以南非洲地区的患者监测。
