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尼日利亚HIV阳性女性的妊娠、产科及新生儿结局

Pregnancy, obstetric and neonatal outcomes in HIV positive Nigerian women.

作者信息

Ezechi O C, Gab-Okafor C V, Oladele D A, Kalejaiye O O, Oke B O, Ohwodo H O, Adu R A, Ekama S O, Musa Z, Onwujekwe D I, David A N, Ujah I A O

机构信息

Clinical Sciences, Division, Nigerian Institute of Medical Research, Lagos Nigeria.

出版信息

Afr J Reprod Health. 2013 Sep;17(3):160-8.

Abstract

While the effect of HIV infection on some maternal outcomes is well established, for some others there is conflicting information on possible association with HIV. In this study we investigated pregnancy and neonatal outcome of HIV positive women in large HIV treatment centre over a period of 84 months. They were managed according to the Nigerian PMTCT protocol. Adverse obstetric and neonatal outcome were observed in 48.3% HIV positives compared 30.3% to the negatives (OR: 2.08; CI: 1.84-2.34). Low birth weight ( OR:2.95; CI:1.95-3.1), preterm delivery (OR:2.05; CI:1.3-3.1), perinatal death (OR:1.9;CI:1.3-3.2), and spontaneous abortion (OR:1.37; CI:1.1-2.3) were factors found to be independently associated with HIV. Low CD4 count (OR: 2.45; CI: 1.34- 4.56) and opportunistic infections (OR: 2.11; CI: 1.56-3.45) were to be associated with adverse obstetric and neonatal outcome. This study confirms the association of HIV, severe immunosuppression and opportunistic infection and adverse obstetric and neonatal outcome.

摘要

虽然HIV感染对某些孕产妇结局的影响已得到充分证实,但对于其他一些结局,关于其与HIV可能存在的关联存在相互矛盾的信息。在本研究中,我们调查了一家大型HIV治疗中心84个月期间HIV阳性女性的妊娠和新生儿结局。她们按照尼日利亚预防母婴传播方案进行管理。48.3%的HIV阳性者出现了不良产科和新生儿结局,而阴性者为30.3%(比值比:2.08;可信区间:1.84 - 2.34)。低出生体重(比值比:2.95;可信区间:1.95 - 3.1)、早产(比值比:2.05;可信区间:1.3 - 3.1)、围产期死亡(比值比:1.9;可信区间:1.3 - 3.2)和自然流产(比值比:1.37;可信区间:1.1 - 2.3)被发现与HIV独立相关。低CD4细胞计数(比值比:2.45;可信区间:1.34 - 4.56)和机会性感染(比值比:2.11;可信区间:1.56 - 3.45)与不良产科和新生儿结局相关。本研究证实了HIV、严重免疫抑制和机会性感染与不良产科和新生儿结局之间的关联。

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