Machado Elizabeth Stankiewicz, Krauss Margot R, Megazzini Karen, Coutinho Conrado Milani, Kreitchmann Regis, Melo Victor Hugo, Pilotto José Henrique, Ceriotto Mariana, Hofer Cristina B, Siberry George K, Watts D Heather
Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Westat, Rockville, MD, USA.
J Infect. 2014 Jun;68(6):572-80. doi: 10.1016/j.jinf.2013.12.018. Epub 2014 Jan 23.
To evaluate the incidence of and risk factors for hypertensive disorders in a cohort of HIV-infected pregnant women.
Hypertensive disorders (HD) including preeclampsia/eclampsia (PE/E) and pregnancy induced hypertension, and risk factors were evaluated in a cohort of HIV-infected pregnant women from Latin America and the Caribbean enrolled between 2002 and 2009. Only pregnant women enrolled for the first time in the study and delivered at ≥20 weeks gestation were analyzed.
HD were diagnosed in 73 (4.8%, 95% CI: 3.8%-6.0%) of 1513 patients; 35 (47.9%) had PE/E. HD was significantly increased among women with a gestational age-adjusted body mass index (gBMI) ≥25 kg/m(2) (OR = 3.1; 95% CI: 1.9-5.0), hemoglobin (Hg) ≥11 g/dL at delivery (OR = 2.1; 95% CI: 1.2-3.6) and age ≥35 years (OR = 1.8; 95% CI: 1.1-3.2). PE/E was increased among women with a gBMI ≥25 kg/m(2) (OR = 3.0; 95% CI: 1.5-6.0) and Hg ≥11 g/dL at delivery (OR = 2.8; 95% CI: 1.2-6.5). A previous history of PE/E increased the risk of PE/E 6.7 fold (95% CI: 1.8-25.5). HAART before conception was associated with PE/E (OR = 2.3; 95% CI: 1.1-4.9).
HIV-infected women, with a previous history of PE/E, a gBMI ≥25 kg/m(2), Hg at delivery ≥11 g/dL and in use of HAART before conception are at an increased risk of developing PE/E during pregnancy.
评估一组感染HIV的孕妇中高血压疾病的发病率及危险因素。
对2002年至2009年间登记入组的来自拉丁美洲和加勒比地区的感染HIV的孕妇队列,评估包括先兆子痫/子痫(PE/E)和妊娠高血压在内的高血压疾病(HD)以及危险因素。仅分析首次入组本研究且妊娠≥20周分娩的孕妇。
1513例患者中有73例(4.8%,95%可信区间:3.8%-6.0%)被诊断为HD;35例(47.9%)患有PE/E。在妊娠年龄校正体重指数(gBMI)≥25 kg/m²的女性中HD显著增加(比值比[OR]=3.1;95%可信区间:1.9-5.0),分娩时血红蛋白(Hg)≥11 g/dL的女性中HD显著增加(OR=2.1;95%可信区间:1.2-3.6),年龄≥35岁的女性中HD显著增加(OR=1.8;95%可信区间:1.1-3.2)。gBMI≥25 kg/m²的女性中PE/E增加(OR=3.0;95%可信区间:1.5-6.0),分娩时Hg≥11 g/dL的女性中PE/E增加(OR=2.8;95%可信区间:1.2-6.5)。既往有PE/E病史使PE/E风险增加6.7倍(95%可信区间:1.8-25.5)。受孕前接受高效抗逆转录病毒治疗(HAART)与PE/E相关(OR=2.3;95%可信区间:1.1-4.9)。
既往有PE/E病史、gBMI≥25 kg/m²、分娩时Hg≥11 g/dL且受孕前使用HAART的感染HIV的女性在孕期发生PE/E的风险增加。