Boyajian Talar, Shah Prakesh S, Murphy Kellie E
Faculty of Medicine, University of Toronto, Toronto ON; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto ON.
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Department of Pediatrics, Mt. Sinai Hospital, Toronto ON; Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto ON.
J Obstet Gynaecol Can. 2012 Feb;34(2):136-141. doi: 10.1016/S1701-2163(16)35156-8.
We sought to determine whether HIV-positive women receiving highly active anti-retroviral therapy (HAART) are at higher risk for preeclampsia than HIV-negative women. Secondary outcomes included comparing the risks of preterm birth, low birth weight, and small for gestational age birth in these women.
In this retrospective matched cohort study, we compared the pregnancy outcomes of HIV-positive women treated with HAART with those of HIV-negative women who gave birth at Mount Sinai Hospital, Toronto, Ontario. Data were ascertained through chart review. Univariate and multivariate logistic regression models were used to compare pregnancy outcomes between the two groups.
Ninety-one HIV-positive pregnant women receiving HAART and 273 HIV-negative pregnant women were identified. After adjusting for confounding factors, there was no difference between HIV-positive and HIV-negative women in the odds of preeclampsia (3.3% vs. 5.1%; adjusted odds ratio [aOR] 0.59; 95% CI 0.11 to 3.08), preterm birth (15.6% vs. 11.4%; aOR 1.70, 95% CI 0.79 to 3.66) or small for gestational age infants (20.2% vs. 8.8%; aOR 2.08, 95% CI 0.89 to 5.24). HIV-positive women treated with HAART had increased odds of giving birth to a low birth weight infant compared to HIV-negative women (20.2% vs. 9.9%; aOR 2.91; 95% CI 1.47 to 5.78).
In this cohort, HIV-positive women on HAART did not demonstrate a higher risk of preeclampsia, preterm birth, or small for gestational age infants; however, they did have a higher risk of having low birth weight infants.
我们试图确定接受高效抗逆转录病毒疗法(HAART)的HIV阳性女性患先兆子痫的风险是否高于HIV阴性女性。次要结局包括比较这些女性早产、低出生体重和小于胎龄儿出生的风险。
在这项回顾性匹配队列研究中,我们比较了在安大略省多伦多市西奈山医院接受HAART治疗的HIV阳性女性与HIV阴性女性的妊娠结局。通过查阅病历确定数据。使用单变量和多变量逻辑回归模型比较两组之间的妊娠结局。
确定了91名接受HAART治疗的HIV阳性孕妇和273名HIV阴性孕妇。在调整混杂因素后,HIV阳性和HIV阴性女性在先兆子痫的几率(3.3%对5.1%;调整后的优势比[aOR]0.59;95%置信区间0.11至3.08)、早产(15.6%对11.4%;aOR 1.70,95%置信区间0.79至3.66)或小于胎龄儿(20.2%对8.8%;aOR 2.08,95%置信区间0.89至5.24)方面没有差异。与HIV阴性女性相比,接受HAART治疗的HIV阳性女性生出低出生体重婴儿的几率增加(20.2%对9.9%;aOR 2.91;95%置信区间1.47至5.78)。
在该队列中,接受HAART治疗的HIV阳性女性未表现出先兆子痫、早产或小于胎龄儿的更高风险;然而,她们生出低出生体重婴儿的风险确实更高。