Maternal-Fetal Medicine Department, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Barcelona, Spain.
AIDS. 2012 Jan 2;26(1):37-43. doi: 10.1097/QAD.0b013e32834db300.
To assess the association between HIV infection and both spontaneous and iatrogenic preterm delivery (PTD), and to explore the impact of HAART on both entities.
A matched retrospective cohort study was carried out on 517 HIV-infected pregnant women who consecutively attended a university referral hospital between 1986 and 2010. Two controls were assigned for each case. They were matched by ethnicity, smoking, maternal age and educational level. Exclusion criteria were multiple pregnancy and active injection drug use (IDU). PTD was defined as delivery less than 37.0 weeks. Spontaneous PTD included preterm premature rupture of membranes. Iatrogenic delivery was considered if medically indicated. Factors associated with PTD among HIV-infected women were analyzed by logistic regression.
A total of 1557 pregnant women were analyzed (519 HIV-infected and 1038 noninfected). The incidence of PTD was 19.7% in HIV-infected women and 8.5% in controls [odds ratio (OR) 2.6; 95% CI 1.9-3.6]. There was a significantly higher incidence of both spontaneous [adjusted OR (AOR) 2.1; 95% confidence interval (CI) 1.5-3.0] and iatrogenic prematurity (AOR 3.2; 95% CI 1.8-5.7). Iatrogenic PTD was significantly associated with the use of HAART during the second half of pregnancy, whereas spontaneous PTD was not related to HAART.
There is a significant association of HIV infection with PTD, both spontaneous and iatrogenic PTD. HAART use was predominantly associated with iatrogenic PTD.
评估 HIV 感染与自发性和医源性早产（PTD）之间的关联，并探讨 HAART 对这两种情况的影响。
对 1986 年至 2010 年间连续在一所大学附属医院就诊的 517 名 HIV 感染孕妇进行了一项匹配的回顾性队列研究。为每个病例分配了两个对照。他们按种族、吸烟、母亲年龄和教育程度进行匹配。排除标准为多胎妊娠和活动性注射吸毒（IDU）。PTD 定义为分娩少于 37.0 周。自发性 PTD 包括早产胎膜早破。如果医学上需要，就认为是医源性分娩。通过 logistic 回归分析 HIV 感染妇女发生 PTD 的相关因素。
共分析了 1557 名孕妇（519 名 HIV 感染孕妇和 1038 名未感染孕妇）。HIV 感染孕妇的 PTD 发生率为 19.7%，对照组为 8.5%[比值比（OR）2.6；95%置信区间（CI）1.9-3.6]。自发性[校正 OR（AOR）2.1；95%CI 1.5-3.0]和医源性早产（AOR 3.2；95%CI 1.8-5.7）的发生率均显著升高。医源性 PTD 与妊娠后半期使用 HAART 显著相关，而自发性 PTD 与 HAART 无关。
HIV 感染与 PTD 显著相关，包括自发性和医源性 PTD。HAART 的使用主要与医源性 PTD 相关。
