From New York State Department of Health, Office of Public Health and Department of Epidemiology, School of Public Health, University at Albany, Albany, New York; New York State Department of Health, Center for Community Health, Albany, New York; New York State Department of Health, Acquired Immunodeficiency Syndrome (AIDS) Institute, New York; New York State Department of Health, AIDS Institute, Albany, New York; New York State Department of Health, Wadsworth Center, Albany, New York; and New York State Department of Health, Center for Community Health and Department of Epidemiology, School of Public Health, University at Albany, Albany, New York.
Obstet Gynecol. 2010 Jun;115(6):1247-1255. doi: 10.1097/AOG.0b013e3181e00955.
To assess perinatal human immunodeficiency virus (HIV) exposure and factors associated with mother-to-child HIV transmission.
A cohort analysis of HIV-exposed births in New York State from 2002 to 2006 was undertaken using routinely collected public health surveillance and regulatory data, including Newborn Screening HIV antibody results, pediatric HIV diagnostic test results, and maternal and pediatric medical record abstractions.
Between January 2002 and December 2006, we identified 3,396 HIV-exposed neonoates. Subsequent analysis of 3,102 (91%) birth events showed that mother-to-child HIV transmission was presumed or confirmed to have occurred in 65 neonates (2.1%) born to 63 mothers. On multivariable analysis, the following significant associations with transmission were identified: maternal HIV diagnosis at or after delivery (odds ratio [OR] 3.24, 95% [CI] 1.15-8.15), maternal acquisition of HIV during pregnancy (OR 15.19, 95% CI 3.98-56.30), illicit substance use during pregnancy (OR 2.66, 95% CI 1.33-5.27), 0-2 prenatal care visits (OR 2.37, 95% CI 1.11-4.91), and neonatal birth weight less than 2,500 g (OR 2.46, 95% CI 1.26-4.74).
Acquisition of HIV during pregnancy is a significant risk factor for mother-to-child HIV transmission and must be addressed along with other known risks to reduce mother-to-child transmission to the greatest extent possible.
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评估围产期人类免疫缺陷病毒（HIV）暴露情况以及与母婴 HIV 传播相关的因素。
采用常规收集的公共卫生监测和监管数据，对 2002 年至 2006 年期间纽约州的 HIV 暴露出生进行队列分析，包括新生儿筛查 HIV 抗体结果、儿科 HIV 诊断检测结果以及母婴病历摘要。
2002 年 1 月至 2006 年 12 月期间，我们共发现 3396 例 HIV 暴露新生儿。对其中 3102 例（91%）分娩事件的进一步分析显示，63 名母亲所生的 65 名新生儿（2.1%）母婴 HIV 传播被假定或确认为已发生。多变量分析显示，与传播相关的显著因素包括：分娩时或分娩后母亲 HIV 诊断（比值比[OR]3.24，95%可信区间[CI]1.15-8.15）、母亲在孕期感染 HIV（OR 15.19，95% CI 3.98-56.30）、孕期使用非法药物（OR 2.66，95% CI 1.33-5.27）、孕期产前护理就诊次数为 0-2 次（OR 2.37，95% CI 1.11-4.91）和新生儿出生体重<2500 g（OR 2.46，95% CI 1.26-4.74）。
孕期感染 HIV 是母婴 HIV 传播的重要危险因素，必须与其他已知危险因素一起加以解决，以尽可能减少母婴传播。
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