• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

2010 - 2015年南非农村地区接受抗逆转录病毒治疗的感染艾滋病毒孕妇的早产和小于胎龄儿结局：一项队列研究的结果

Preterm delivery and small-for-gestation outcomes in HIV-infected pregnant women on antiretroviral therapy in rural South Africa: Results from a cohort study, 2010-2015.

作者信息

Chetty Terusha, Thorne Claire, Coutsoudis Anna

机构信息

Africa Health Research Institute, Mtubatuba, KwaZulu-Natal, South Africa.

Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.

出版信息

PLoS One. 2018 Feb 22;13(2):e0192805. doi: 10.1371/journal.pone.0192805. eCollection 2018.

DOI:10.1371/journal.pone.0192805
PMID:29470508
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5823389/
Abstract

OBJECTIVES

Increasingly more women conceive on antiretroviral therapy (ART) with non-nucleoside reverse transcriptase-based regimens. This study assessed the effect of preconception tenofovir disoproxil fumarate (TDF)-lamivudine (3TC)/emtricitabine (FTC)-efavirenz (EFV) and post-conception TDF-(3TC/FTC)-EFV (versus other regimens) on preterm delivery (PTD) and small-for-gestational age (SGA) births.

METHODS

We analysed data of 2549 HIV-infected women attending antenatal clinics in KwaZulu-Natal from 2010 through 2015 in this retrospective cohort study. Preconception, TDF-(3TC/FTC)-EFV was compared to nevirapine (NVP)-based regimens and other 3-drug EFV-based regimens. Post-conception, TDF-(3TC/FTC)-EFV was compared to NVP-based ART and zidovudine (ZDV) prophylaxis. Outcomes included PTD <37 weeks and SGA births. Generalized linear mixed effects were used to fit logistic regression models to account for repeat pregnancies.

RESULTS

Among 2549 singleton live births, 10.4% (n = 264) were PTD and 10.4% (n = 265) SGA. PTD declined from 16.3% in 2010 to 9.3% in 2015 and SGA remained stable from 9.9% in 2010 to 10% in 2015. Preconception NVP-based regimens [adjusted odds ratio (aOR) 0.66; 95% CI 0.27-1.63] and other 3-drug EFV-based regimens (aOR 0.72; 95% CI 0.24-2.12) were not associated with PTD versus TDF-(3TC/FTC)-EFV. NVP-based (aOR 0.75; 95% CI 0.40-1.42) and other 3-drug EFV-based regimens (aOR 1.55; 95% CI 0.76-3.16) were not associated with SGA births versus TDF-(3TC/FTC)-EFV. Post-conception NVP-based ART (1.77; 95% CI 0.89-3.51) and ZDV (1.03; 95% CI 0.68-1.58) were not associated with PTD versus TDF-(3TC/FTC)-EFV. NVP-based ART (1.55; 95% CI 0.66-3.61) and ZDV (0.89; 95% CI 0.53-1.47) were not associated with SGA versus TDF-(3TC/FTC)-EFV.

CONCLUSIONS

Preconception TDF-(3TC/FTC)-EFV and post-conception TDF-(3TC/FTC)-EFV were not associated with PTD or SGA, compared with other regimens. Increasing ART use merits further study of the optimum ART regimen for safe birth outcomes.

摘要

目的

越来越多的女性在接受基于非核苷类逆转录酶的抗逆转录病毒疗法（ART）时怀孕。本研究评估了孕前替诺福韦酯（TDF）-拉米夫定（3TC）/恩曲他滨（FTC）-依非韦伦（EFV）以及孕后TDF-（3TC/FTC）-EFV（与其他方案相比）对早产（PTD）和小于胎龄（SGA）儿出生的影响。

方法

在这项回顾性队列研究中，我们分析了2010年至2015年在夸祖鲁-纳塔尔省产前诊所就诊的2549名感染HIV的女性的数据。孕前，将TDF-（3TC/FTC）-EFV与基于奈韦拉平（NVP）的方案以及其他基于三种药物的EFV方案进行比较。孕后，将TDF-（3TC/FTC）-EFV与基于NVP的ART和齐多夫定（ZDV）预防方案进行比较。结局包括孕周<37周的早产和SGA儿出生。使用广义线性混合效应来拟合逻辑回归模型，以考虑重复妊娠的情况。

结果

在2549例单胎活产中，10.4%（n = 264）为早产，10.4%（n = 265）为SGA儿。早产率从2010年的16.3%降至2015年的9.3%，SGA儿出生率从2010年的9.9%稳定至2015年的10%。与TDF-（3TC/FTC）-EFV相比，孕前基于NVP的方案[调整优势比（aOR）0.66；95%置信区间（CI）0.27 - 1.63]和其他基于三种药物的EFV方案（aOR 0.72；95% CI 0.24 - 2.12）与早产无关。与TDF-（3TC/FTC）-EFV相比，基于NVP的方案（aOR 0.75；95% CI 0.40 - 1.42）和其他基于三种药物的EFV方案（aOR 1.55；95% CI 0.76 - 3.16）与SGA儿出生无关。孕后，与TDF-（3TC/FTC）-EFV相比，基于NVP的ART（1.77；95% CI 0.89 - 3.51）和ZDV（1.03；95% CI 0.68 - 1.58）与早产无关。与TDF-（3TC/FTC）-EFV相比，基于NVP的ART（1.55；95% CI 0.66 - 3.61）和ZDV（0.89；95% CI 0.53 - 1.47）与SGA儿无关。

结论

与其他方案相比，孕前TDF-（3TC/FTC）-EFV和孕后TDF-（3TC/FTC）-EFV与早产或SGA儿无关。增加ART的使用值得进一步研究以确定实现安全分娩结局的最佳ART方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/5823389/28f6ed670557/pone.0192805.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/5823389/81334c71aa47/pone.0192805.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/5823389/28f6ed670557/pone.0192805.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/5823389/81334c71aa47/pone.0192805.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/5823389/28f6ed670557/pone.0192805.g002.jpg

相似文献

1
Preterm delivery and small-for-gestation outcomes in HIV-infected pregnant women on antiretroviral therapy in rural South Africa: Results from a cohort study, 2010-2015.2010 - 2015年南非农村地区接受抗逆转录病毒治疗的感染艾滋病毒孕妇的早产和小于胎龄儿结局：一项队列研究的结果
PLoS One. 2018 Feb 22;13(2):e0192805. doi: 10.1371/journal.pone.0192805. eCollection 2018.
2
Comparative Safety of Antiretroviral Treatment Regimens in Pregnancy.孕期抗逆转录病毒治疗方案的比较安全性
JAMA Pediatr. 2017 Oct 2;171(10):e172222. doi: 10.1001/jamapediatrics.2017.2222.
3
Emulating a target trial of antiretroviral therapy regimens started before conception and risk of adverse birth outcomes.模拟在受孕前开始的抗逆转录病毒治疗方案的目标试验与不良出生结局的风险。
AIDS. 2018 Jan 2;32(1):113-120. doi: 10.1097/QAD.0000000000001673.
4
Reassuring Birth Outcomes With Tenofovir/Emtricitabine/Efavirenz Used for Prevention of Mother-to-Child Transmission of HIV in Botswana.在博茨瓦纳使用替诺福韦/恩曲他滨/依非韦伦预防母婴传播艾滋病毒的令人安心的分娩结局
J Acquir Immune Defic Syndr. 2016 Apr 1;71(4):428-36. doi: 10.1097/QAI.0000000000000847.
5
Effects of Highly Active Antiretroviral Therapy on Albuminuria in HIVinfected Persons.高效抗逆转录病毒疗法对 HIV 感染者蛋白尿的影响。
Infect Disord Drug Targets. 2020;20(3):374-384. doi: 10.2174/1871526519666190807155025.
6
Birth Outcomes for Pregnant Women with HIV Using Tenofovir-Emtricitabine.替诺福韦-恩曲他滨治疗的 HIV 感染孕妇的妊娠结局。
N Engl J Med. 2018 Apr 26;378(17):1593-1603. doi: 10.1056/NEJMoa1701666.
7
Subsequent pregnancies in the IMPAACT 2010/VESTED Trial: high rate of adverse outcomes in women living with HIV.IMPAACT 2010/VESTED试验中的后续妊娠：感染艾滋病毒女性不良结局发生率高。
J Acquir Immune Defic Syndr. 2024 Oct;97(2):150-155. doi: 10.1097/qai.0000000000003473.
8
Tenofovir disoproxil fumarate, emtricitabine, and efavirenz versus fixed-dose zidovudine/lamivudine and efavirenz in antiretroviral-naive patients: virologic, immunologic, and morphologic changes--a 96-week analysis.初治抗逆转录病毒治疗患者中，替诺福韦酯富马酸盐、恩曲他滨和依非韦伦与固定剂量齐多夫定/拉米夫定和依非韦伦的比较：病毒学、免疫学和形态学变化——一项96周分析
J Acquir Immune Defic Syndr. 2006 Dec 15;43(5):535-40. doi: 10.1097/01.qai.0000245886.51262.67.
9
Tenofovir disoproxil fumarate, emtricitabine, and efavirenz compared with zidovudine/lamivudine and efavirenz in treatment-naive patients: 144-week analysis.初治患者中替诺福韦酯富马酸盐、恩曲他滨与依非韦伦联合用药对比齐多夫定/拉米夫定与依非韦伦联合用药：144周分析
J Acquir Immune Defic Syndr. 2008 Jan 1;47(1):74-8. doi: 10.1097/QAI.0b013e31815acab8.
10
Efficacy and safety of three antiretroviral regimens for initial treatment of HIV-1: a randomized clinical trial in diverse multinational settings.三种抗逆转录病毒方案治疗 HIV-1 初治的疗效和安全性：多种族多国环境下的随机临床试验。
PLoS Med. 2012;9(8):e1001290. doi: 10.1371/journal.pmed.1001290. Epub 2012 Aug 14.

引用本文的文献

1
Fetoplacental arteriolar dysfunction in placentas of HIV-exposed, small for gestational age birthweight neonates.暴露于HIV、出生体重小于孕周的新生儿胎盘的胎儿胎盘小动脉功能障碍。
AIDS. 2025 Aug 1;39(10):1353-1363. doi: 10.1097/QAD.0000000000004242. Epub 2025 May 21.
2
Preterm birth among women with HIV: impact of preconception cART initiation.HIV 感染女性的早产：孕前 cART 起始的影响。
AIDS. 2024 Oct 1;38(12):1749-1757. doi: 10.1097/QAD.0000000000003979. Epub 2024 Jul 17.
3
No increased in utero and peripartum HIV acquisition risk in HIV-exposed preterm infants.

本文引用的文献

1
Comparative Safety of Antiretroviral Treatment Regimens in Pregnancy.孕期抗逆转录病毒治疗方案的比较安全性
JAMA Pediatr. 2017 Oct 2;171(10):e172222. doi: 10.1001/jamapediatrics.2017.2222.
2
Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.抗逆转录病毒疗法用于预防围产期HIV感染的益处与风险
N Engl J Med. 2016 Nov 3;375(18):1726-1737. doi: 10.1056/NEJMoa1511691.
3
Cohort profile: the Hlabisa pregnancy cohort, KwaZulu-Natal, South Africa.队列简介：南非夸祖鲁-纳塔尔省的赫拉比萨妊娠队列。
暴露于HIV的早产儿在子宫内和围产期感染HIV的风险没有增加。
South Afr J HIV Med. 2023 Oct 19;24(1):1509. doi: 10.4102/sajhivmed.v24i1.1509. eCollection 2023.
4
Safety surveillance for PrEP in pregnant and breastfeeding women.孕妇和哺乳期妇女中暴露前预防的安全性监测。
Front Reprod Health. 2023 Sep 29;5:1221101. doi: 10.3389/frph.2023.1221101. eCollection 2023.
5
Three-year outcomes for women newly initiated on lifelong antiretroviral therapy during pregnancy - Malawi option B.孕期新开始接受终身抗逆转录病毒治疗的女性的 3 年结局——马拉维选项 B。
AIDS Res Ther. 2023 Jun 12;20(1):37. doi: 10.1186/s12981-023-00523-1.
6
Adverse pregnancy outcomes associated with antiretroviral therapy initiated before pregnancy and during pregnancy: a retrospective study in Hubei province, China.孕前及孕期开始抗逆转录病毒治疗相关的不良妊娠结局：中国湖北省的一项回顾性研究
Front Med (Lausanne). 2023 May 18;10:1158962. doi: 10.3389/fmed.2023.1158962. eCollection 2023.
7
Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania.尼日利亚、肯尼亚、乌干达和坦桑尼亚前瞻性孕妇 HIV 感染队列中围产期抑郁症状与病毒未抑制的关系。
AIDS Behav. 2023 Mar;27(3):783-795. doi: 10.1007/s10461-022-03810-6. Epub 2022 Oct 9.
8
Clinical and programmatic outcomes of HIV-exposed infants enrolled in care at geographically diverse clinics, 1997-2021: A cohort study.1997-2021 年在地理分布不同的诊所接受治疗的 HIV 暴露婴儿的临床和项目结局：一项队列研究。
PLoS Med. 2022 Sep 15;19(9):e1004089. doi: 10.1371/journal.pmed.1004089. eCollection 2022 Sep.
9
Pregnancy and Birth Outcomes Among Women on Antiretroviral Therapy: A Long-term Retrospective Analysis of Data from a Major Tertiary Hospital in North Central Nigeria.接受抗逆转录病毒治疗的女性的妊娠和分娩结局：对尼日利亚中北部一家大型三级医院的数据进行的长期回顾性分析。
Int J MCH AIDS. 2021;10(2):183-190. doi: 10.21106/ijma.511. Epub 2021 Oct 28.
10
Maternal HIV infection is associated with distinct systemic cytokine profiles throughout pregnancy in South African women.南非妇女的母体 HIV 感染与整个孕期独特的全身细胞因子谱相关。
Sci Rep. 2021 May 12;11(1):10079. doi: 10.1038/s41598-021-89551-3.
BMJ Open. 2016 Oct 17;6(10):e012088. doi: 10.1136/bmjopen-2016-012088.
4
Antiretroviral Therapy and Pregnancy Outcomes in Developing Countries: A Systematic Review.发展中国家的抗逆转录病毒疗法与妊娠结局：一项系统评价
Int J MCH AIDS. 2015;3(1):31-43.
5
INTERGROWTH-21st very preterm size at birth reference charts.INTERGROWTH-21st极早产出生时大小参考图表。
Lancet. 2016 Feb 27;387(10021):844-5. doi: 10.1016/S0140-6736(16)00384-6. Epub 2016 Feb 18.
6
Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis.与母婴 HIV 感染相关的围产期结局：系统评价和荟萃分析。
Lancet HIV. 2016 Jan;3(1):e33-48. doi: 10.1016/S2352-3018(15)00207-6. Epub 2015 Nov 27.
7
Reassuring Birth Outcomes With Tenofovir/Emtricitabine/Efavirenz Used for Prevention of Mother-to-Child Transmission of HIV in Botswana.在博茨瓦纳使用替诺福韦/恩曲他滨/依非韦伦预防母婴传播艾滋病毒的令人安心的分娩结局
J Acquir Immune Defic Syndr. 2016 Apr 1;71(4):428-36. doi: 10.1097/QAI.0000000000000847.
8
Antiretroviral Therapy in Relation to Birth Outcomes among HIV-infected Women: A Cohort Study.感染艾滋病毒女性的抗逆转录病毒治疗与分娩结局的关系：一项队列研究。
J Infect Dis. 2016 Apr 1;213(7):1057-64. doi: 10.1093/infdis/jiv389. Epub 2015 Aug 10.
9
Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection.早期无症状HIV感染中抗逆转录病毒治疗的启动
N Engl J Med. 2015 Aug 27;373(9):795-807. doi: 10.1056/NEJMoa1506816. Epub 2015 Jul 20.
10
International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project.国际胎龄别、性别新生儿体重、身长及头围标准：INTERGROWTH-21st 项目新生儿横断面研究。
Lancet. 2014 Sep 6;384(9946):857-68. doi: 10.1016/S0140-6736(14)60932-6.