在 Cipto Mangunkusumo 医院分娩的 HIV 感染妇女的妊娠情况和婴儿结局。

Pregnancy Profile and Infant Outcomes Among HIV Infected Women Who Delivered in Cipto Mangunkusumo Hospital.

机构信息

Departement of Obstetric and Gynecology Universitas Indonesia.

出版信息

Acta Med Indones. 2020 Jan;52(1):55-62.

Abstract

BACKGROUND

HIV infection in pregnancy is a big concern for the future of our nation. The virus can be transmitted to the baby through pregnancy, childbirth and during breastfeeding which rendering to early detection and intervention. The aim of this study was to describe the transmission prevention cascade among our patient.

METHODS

this was a retrospective cohort study of HIV vertical transmission. The inclusion criteria was pregnant women with HIV infection who have antenatal care in Cipto Mangunkusumo Hospital from January 2013 up to December 2018. Data was retrieved from medical record, HIV registry and laboratory results. The included data were demographic, risk of infection, obstetrical data, mode of delivery, ARV history, laboratory history in mother and infant. Data was presented as descriptive.

RESULTS

there was 138 HIV pregnant women included as study subjects. Most women were at 25-29 years old (39.85%), as housewife (41.30%), with history of more than one sexual partners (50.73%). The subjects was mostly multigravida (77.5%), first visit to RSCM in third trimester (98.6%), with history of antenatal care >4 times (48.6%), singleton fetus (99.3%), and delivered by C-section (84.1%). HIV diagnosis was done during pregnancy (73.53%), and already on antiretroviral (ARV) for more than 6 months (50.7%). There was 78% subjects with CD4 (24% subjects with <200 cells/mL) and 84% with viral load data (36% with viral load >200 copies/uL). Around 72.5% infants born with birth weight 2500-3500g. Almost all infant received ARV prophylaxis (97.9%) and formula feeding. PCR HIV was examined on 16 infant on 6 weeks of age and and 13 on 6 month age. There was 1 infant with viral load results >400 copies/ml which immediately refered to Pediatric HIV clinic. Bivariate analysis showed significant correlation between maternal ARV consumption and infant result at birth (P=0.05). Maternal CD4 level was not significantly correlate with neonatal virology status (P=0.12).

CONCLUSION

HIV diagnosis in pregnant women is important, since ARV administration on early pregnancy significantly reduce vertical transmission. ARV prophylaxis protocols is important to prevent HIV infection on infant.

摘要

背景

艾滋病病毒感染是我们国家未来的一大隐患。病毒可以通过妊娠、分娩和哺乳期传播给婴儿，因此需要早期发现和干预。本研究旨在描述我们患者的传播预防链。

方法

这是一项关于 HIV 垂直传播的回顾性队列研究。纳入标准为 2013 年 1 月至 2018 年 12 月在 Cipto Mangunkusumo 医院进行产前护理的 HIV 感染孕妇。数据从病历、HIV 登记册和实验室结果中检索。纳入的数据包括人口统计学、感染风险、产科数据、分娩方式、抗逆转录病毒治疗史、母婴实验室史。数据以描述性呈现。

结果

共纳入 138 名 HIV 孕妇作为研究对象。大多数女性年龄在 25-29 岁（39.85%），是家庭主妇（41.30%），有多个性伴侣（50.73%）。受试者多为多产妇（77.5%），首次就诊于 RSCM 在孕晚期（98.6%），产前护理>4 次（48.6%），单胎（99.3%），剖宫产（84.1%）。HIV 诊断在妊娠期间进行（73.53%），抗逆转录病毒（ARV）治疗>6 个月（50.7%）。84%的女性有 CD4 数据（24%的女性<200 个细胞/ml），84%有病毒载量数据（36%的病毒载量>200 拷贝/uL）。约 72.5%的婴儿出生体重为 2500-3500g。几乎所有婴儿都接受了 ARV 预防（97.9%）和配方奶喂养。16 名婴儿在 6 周龄和 13 名婴儿在 6 月龄时进行了 PCR HIV 检测。有 1 名婴儿的病毒载量结果>400 拷贝/ml，立即转介至儿科 HIV 诊所。二变量分析显示，母亲 ARV 消耗与婴儿出生时的结果之间存在显著相关性（P=0.05）。母亲 CD4 水平与新生儿病毒学状态无显著相关性（P=0.12）。