Aaron Erika, Bonacquisti Alexa, Mathew Leny, Alleyne Gregg, Bamford Laura P, Culhane Jennifer F
Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, 1427 Vine Street, 5th Floor, Philadelphia, PA 19102, USA.
Infect Dis Obstet Gynecol. 2012;2012:135030. doi: 10.1155/2012/135030. Epub 2012 Jun 20.
To determine rate and factors associated with small-for-gestational-age (SGA) births to women with HIV.
Prospective data were collected from 183 pregnant women with HIV in an urban HIV prenatal clinic, 2000-2011. An SGA birth was defined as less than the 10th or 3rd percentile of birth weight distribution based upon cut points developed using national vital record data. Bivariate analysis utilized chi-squared and t-tests, and multiple logistic regression analyses were used.
The prevalence of SGA was 31.2% at the 10th and 12.6% at the 3rd percentile. SGA at the 10th (OR 2.77; 95% CI, 1.28-5.97) and 3rd (OR 3.64; 95% CI, 1.12-11.76) percentiles was associated with cigarette smoking. Women with CD4 count>200 cells/mm3 at the first prenatal visit were less likely to have an SGA birth at the 3rd percentile (OR 0.29; 95% CI, 0.10-0.86). Women taking NNRTI were less likely to have an SGA infant at the 10th (OR 0.28; 95% CI, 0.10-0.75) and 3rd (OR 0.16; 95% CI, 0.03-0.91) percentiles compared to those women on PIs.
In this cohort with high rates of SGA, severity of HIV disease, not ART, was associated with SGA births after adjusting for sociodemographic, medication, and disease severity.
确定感染艾滋病毒的妇女发生小于胎龄儿（SGA）出生的发生率及相关因素。
2000年至2011年，在一家城市艾滋病毒产前诊所收集了183名感染艾滋病毒的孕妇的前瞻性数据。根据利用国家生命记录数据制定的切点，SGA出生定义为出生体重分布低于第10百分位数或第3百分位数。采用卡方检验和t检验进行双变量分析，并进行多因素逻辑回归分析。
第10百分位数时SGA的患病率为31.2%，第3百分位数时为12.6%。第10百分位数（比值比[OR]为2.77；95%置信区间[CI]为1.28 - 5.97）和第3百分位数（OR为3.64；95% CI为1.12 - 11.76）的SGA与吸烟有关。首次产前检查时CD4细胞计数>200个/立方毫米的妇女在第3百分位数时发生SGA出生的可能性较小（OR为0.29；95% CI为0.10 - 0.86）。与服用蛋白酶抑制剂（PI）的妇女相比，服用非核苷类逆转录酶抑制剂（NNRTI）的妇女在第10百分位数（OR为0.28；95% CI为0.10 - 0.75）和第3百分位数（OR为0.16；95% CI为0.03 - 0.91）时生出SGA婴儿的可能性较小。
在这个SGA发生率较高的队列中，在调整了社会人口统计学、药物治疗和疾病严重程度后，艾滋病毒疾病的严重程度而非抗逆转录病毒治疗（ART）与SGA出生有关。
