高效抗逆转录病毒治疗（HAART）时代和计划性剖宫产分娩时 HIV 感染妇女的产后避孕偏好。

Postpartum contraceptive preferences of HIV-infected women in the era of highly active antiretroviral therapy (HAART) and scheduled cesarean deliveries.

机构信息

Department of Obstetrics of Gynecology, Washington University in St Louis School of Medicine, MO 63110, USA.

出版信息

Contraception. 2011 Aug;84(2):150-4. doi: 10.1016/j.contraception.2010.11.001. Epub 2010 Dec 28.

DOI:10.1016/j.contraception.2010.11.001

PMID:21757056

Abstract

BACKGROUND

We sought to determine if postpartum tubal ligation among HIV-infected women changed with the introduction of highly active antiretroviral therapy (HAART) and scheduled cesarean delivery.

METHODS

Retrospective cohort study of HIV-infected women delivered before (Pre-HAART) and after (Post-HAART) the introduction of HAART and scheduled cesarean delivery. Rates of the primary outcome, postpartum tubal ligation (PPTL), were compared by univariable and multivariable analyses.

RESULTS

We found that 34.5% (60/174) of women in the Post-HAART period chose PPTL, compared to 22.0% (18/82) in the Pre-HAART period [unadjusted OR=1.87 (95% CI 1.02-3.44), p=.04]. When stratified by mode of delivery, rates of PPTL were not significantly different between the two periods. Similarly, in multivariable analysis controlling for confounders, rates of PPTL were not different between the two periods [adjusted OR=1.40 (95% CI=0.66-2.99), p=.39].

CONCLUSIONS

HIV-infected women on HAART are overall more likely to have PPTL, but cesarean delivery appears to be the facilitator of this choice.

摘要

背景

我们旨在确定在引入高效抗逆转录病毒疗法（HAART）和计划剖宫产分娩后，HIV 感染妇女的产后输卵管结扎术是否发生了变化。

方法

对接受 HAART 前（Pre-HAART）和 HAART 后（Post-HAART）以及计划剖宫产分娩的 HIV 感染妇女进行回顾性队列研究。通过单变量和多变量分析比较主要结局，即产后输卵管结扎术（PPTL）的发生率。

结果

我们发现，在 HAART 后时期，有 34.5%（60/174）的妇女选择了 PPTL，而在 HAART 前时期，这一比例为 22.0%（18/82）[未调整的 OR=1.87（95%CI 1.02-3.44），p=.04]。按分娩方式分层后，两个时期的 PPTL 发生率没有显著差异。同样，在多变量分析中控制混杂因素后，两个时期的 PPTL 发生率也没有差异[调整后的 OR=1.40（95%CI=0.66-2.99），p=.39]。