Arikan Y, Burdge D R
Division of Infectious Diseases;
Can J Infect Dis. 1998 Sep;9(5):301-9. doi: 10.1155/1998/274694.
The incidence and prevalence of human immunodeficiency virus (HIV) infection in women of child-bearing age continue to increase both internationally and in Canada. The care of HIV-infected pregnant women is complex, and multiple issues must be addressed, including the current and future health of the woman, minimization of the risk of maternal-infant HIV transmission, and maintenance of the well-being of the fetus and neonate. Vertical transmission of HIV can occur in utero, intrapartum and postpartum, but current evidence suggests that the majority of transmission occurs toward end of term, or during labour and delivery. Several maternal and obstetrical factors influence transmission rates, which can be reduced by optimal medical and obstetrical care. Zidovudine therapy has been demonstrated to reduce maternal-infant transmission significantly, but several issues, including the short and long term safety of antiretrovirals and the optimal use of combination antiretroviral therapy in pregnancy, remain to be defined. It is essential that health care workers providing care to these women fully understand the natural history of HIV disease in pregnancy, the factors that affect vertical transmission and the management issues during pregnancy. Close collaboration among a multidisciplinary team of knowledgeable health professionals and, most importantly, the woman herself can improve both maternal and infant outcomes.
在国际上以及加拿大，育龄期女性感染人类免疫缺陷病毒（HIV）的发病率和患病率持续上升。对感染HIV的孕妇进行护理十分复杂，必须解决多个问题，包括该女性当前和未来的健康状况、将母婴HIV传播风险降至最低，以及维持胎儿和新生儿的健康。HIV的垂直传播可发生在子宫内、分娩期和产后，但目前的证据表明，大多数传播发生在妊娠晚期，或分娩过程中。一些母体和产科因素会影响传播率，通过最佳的医疗和产科护理可以降低传播率。齐多夫定疗法已被证明可显著降低母婴传播，但包括抗逆转录病毒药物的短期和长期安全性以及孕期联合抗逆转录病毒疗法的最佳使用等几个问题仍有待明确。为这些女性提供护理的医护人员必须充分了解孕期HIV疾病的自然史、影响垂直传播的因素以及孕期的管理问题。由知识渊博的健康专业人员组成的多学科团队，最重要的是女性自身之间的密切合作，可以改善母婴结局。
