Irmandade da Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil.
Int J Gynaecol Obstet. 2011 Aug;114(2):91-6. doi: 10.1016/j.ijgo.2011.02.008. Epub 2011 May 26.
To evaluate respiratory morbidity (RM) in HIV-exposed newborns according to mode of delivery.
The NISDI Perinatal/LILAC prospective cohort studies enrolled HIV-infected pregnant women and their newborns in Latin America and the Caribbean. Associations between RM and delivery mode or other characteristics were evaluated.
Between September 2002 and December 2009, 1630 women were enrolled, and 1443 mother-infant pairs met the inclusion criteria. There were 561 vaginal (VD), 269 cesarean before labor and membrane rupture (SCS) for preventing mother-to-child transmission (SCS-PMTCT), 248 other SCS, and 365 cesarean after labor and/or ruptured membranes (NSCS) deliveries. In total, 108 (7.5%) newborns had RM: 49 had respiratory distress syndrome (RDS), 39 had transient tachypnea (TTN), and 28 had other events (7 newborns had >1 RM event). Delivery mode was associated with RDS (P<0.005) and TTN (P<0.001). The proportion with RDS and TTN was lowest for VD (1.6% and 0.5%, respectively), highest for NSCS (4.9% and 4.7%), and intermediate for SCS-PMTCT (3.0% and 2.6%). Newborns with RDS or TTN were hospitalized longer (median +1day) than those without. A minority required ventilatory support (RDS, 24.5%-28.6%; TTN, 2.6%-15.4%).
SCS-PMTCT is relatively safe for newborns of HIV-infected women.
根据分娩方式评估 HIV 暴露新生儿的呼吸系统发病率（RM）。
NISDI 围产期/LILAC 前瞻性队列研究在拉丁美洲和加勒比地区招募了感染 HIV 的孕妇及其新生儿。评估了 RM 与分娩方式或其他特征之间的关联。
2002 年 9 月至 2009 年 12 月，共纳入 1630 名妇女，1443 对母婴符合纳入标准。561 例为阴道分娩（VD），269 例为为预防母婴传播而进行的计划性剖宫产（SCS-PMTCT），248 例为其他 SCS，365 例为产后和/或胎膜破裂的剖宫产（NSCS）。共有 108 例（7.5%）新生儿发生 RM：49 例患有呼吸窘迫综合征（RDS），39 例患有短暂性呼吸急促（TTN），28 例患有其他疾病（7 例新生儿患有>1 种 RM 疾病）。分娩方式与 RDS（P<0.005）和 TTN（P<0.001）相关。VD 组 RDS 和 TTN 的比例最低（分别为 1.6%和 0.5%），NSCS 组最高（分别为 4.9%和 4.7%），SCS-PMTCT 组居中（分别为 3.0%和 2.6%）。患有 RDS 或 TTN 的新生儿住院时间更长（中位数+1 天）。少数需要呼吸机支持（RDS，24.5%-28.6%；TTN，2.6%-15.4%）。
对于 HIV 感染妇女的新生儿，SCS-PMTCT 相对安全。
