HIV in Young People Network (HYPNet), London, UK.
HIV Med. 2012 May;13(5):304-8. doi: 10.1111/j.1468-1293.2011.00967.x. Epub 2011 Dec 4.
Adolescents with HIV infection acquired perinatally or in early childhood are becoming sexually active, but little is known about fertility and pregnancy outcomes. Multicentre data on pregnancy outcomes in this population are described here.
A retrospective case note review of pregnant women with perinatal/early acquired HIV infection, conceiving before 1 September 2009 and attending participating centres in the UK and Ireland, was carried out.
Among 252 women with perinatal/early acquired infection aged 12 years and older under follow-up in 21 centres, 42 pregnancies were reported in 30 women (19 women with a single pregnancy, 10 women with two pregnancies, and one woman with three pregnancies). Fifteen women (50%) had previous AIDS-defining diagnoses. The median age at first reported pregnancy was 18 years (range 14-22 years). Of the 42 pregnancies, 34 (81%) were reportedly unplanned, 31 (74%) involved regular partners, and in 21 (50%) of the 42 pregnancies the partners were reported to be unaware of maternal HIV status. Fifteen of the 42 pregnancies (36%) were electively terminated, six of the 42 (14%) resulted in first-trimester miscarriages and 21 of the 42 (50%) resulted in live births. Maternal viral load was detectable close to delivery in seven of 21 pregnancies (33%). Four infants required neonatal intensive care, three of whom were delivered preterm. One infant is HIV infected, there are ongoing concerns about the development of three of 21 infants (14%), and two of 21 (10%) have been fostered.
Despite access to ongoing sexual health and contraceptive services, unplanned pregnancies are occurring in young women growing up with HIV. Pregnancy care and prevention of onward transmission require complex case management for this emerging population.
感染艾滋病毒的青少年，无论是先天感染还是婴幼儿时期感染，现在都开始具有生育能力且有性行为，但是对于该人群的生育力和妊娠结局知之甚少。本研究描述了这一人群的妊娠结局的多中心数据。
对在英国和爱尔兰的参与中心接受随访的先天/婴幼儿时期感染艾滋病毒且年龄在 12 岁及以上的、于 2009 年 9 月 1 日前受孕的孕妇的病历进行回顾性病例分析。
在 21 个中心中，有 252 名先天/婴幼儿时期感染的妇女接受了随访，年龄在 12 岁及以上，30 名妇女报告了 42 次妊娠（19 名妇女单次妊娠，10 名妇女两次妊娠，1 名妇女三次妊娠）。15 名妇女（50%）有既往艾滋病定义性诊断。首次报告妊娠的中位年龄为 18 岁（范围 14-22 岁）。42 次妊娠中，34 次（81%）为非计划妊娠，31 次（74%）涉及固定伴侣，21 次妊娠（50%）中伴侣未被告知母亲的 HIV 状况。15 次妊娠（36%）被选择性终止，42 次妊娠中有 6 次（14%）导致孕早期流产，42 次妊娠中有 21 次（50%）导致活产。21 次妊娠中有 7 次（33%）接近分娩时母亲的病毒载量可检测到。4 名婴儿需要新生儿重症监护，其中 3 名早产儿分娩。1 名婴儿感染 HIV，21 名婴儿中有 3 名（14%）发育持续存在问题，21 名婴儿中有 2 名（10%）被寄养。
尽管有机会获得持续的性健康和避孕服务，但感染艾滋病毒的年轻女性仍会意外怀孕。对于这一新兴人群，妊娠护理和预防母婴传播需要复杂的病例管理。
