Al Hasani Nada Ali Salim, Al Dughaishi Tamima, Balkhair Abdullah A
Obstetric and Gynecology Residency Training Program, Oman Medical Speciality Board, Muscat, Oman.
Fetomaternal Medicine, Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Muscat, Oman.
Oman Med J. 2021 Nov 30;36(6):e321. doi: 10.5001/omj.2021.111. eCollection 2021 Nov.
We sought to investigate the prevalence of HIV in pregnant women and the maternal, obstetrical, and neonatal outcomes over 13 years (2005-2017) at Sultan Qaboos University Hospital, a tertiary hospital in Muscat, Oman.
Our study design was a retrospective descriptive cross-sectional study of HIV-positive women in the department of obstetrics and gynecology. We had an unlimited sample size due to the rarity of the disease. We aimed to include all pregnant Omani women who tested positive for HIV in their antenatal screening from 1 January 2005 to 31 December 2017. The patient records were reviewed using the hospital information system service.
There were a total of 13 688 women with 104 281 pregnancies over the study period. The prevalence of Omani pregnant women with HIV was 0.1% (1:1000) with 0.03% of seropositive pregnancies (3:10 000). Of these seropositive pregnancies, 78.6% were known HIV carriers, while 21.4% were newly diagnosed cases. The live birth rate was 90.3%, with 9.7% resulting in miscarriage. All the miscarriages were to known HIV-positive mothers who were managed in accordance with international guidelines. Of the live births, 10.7% were unknown HIV-positive mothers with a mean gestational age of 39.67 weeks and a mean birth weight of 3.2 kg. The rate of mother-to-child transmission (MTCT) of HIV in this group was 33.3%. In contrast, 89.3% of the live births to known HIV-positive mothers delivered neonates with a mean gestational age of 37.4 weeks and a mean birth weight of 2.6 kg with 0.0% MTCT. Modes of delivery, antepartum, intrapartum and postpartum complications as well as long-term neonatal outcomes were analyzed according to the status of the mother at first presentation.
Strategies have been placed by programs in Oman to focus on the wellbeing of pregnant women and the protection of newborns against HIV infection. Strict implementations on preventing MTCT allowed preventing HIV in children possible. Antiretroviral therapy significantly reduces vertical transmission of HIV, in addition to abstinence of breastfeeding. More importantly, all HIV-positive pregnant women should follow the prevention of MTCT programs set out by the Ministry of Health.
我们试图调查阿曼马斯喀特一家三级医院——苏丹卡布斯大学医院13年（2005 - 2017年）间孕妇中的艾滋病毒感染率以及孕产妇、产科和新生儿结局。
我们的研究设计是对妇产科艾滋病毒阳性女性进行回顾性描述性横断面研究。由于该疾病罕见，我们的样本量不受限制。我们旨在纳入2005年1月1日至2017年12月31日期间产前筛查艾滋病毒呈阳性的所有阿曼孕妇。使用医院信息系统服务对患者记录进行审查。
在研究期间，共有13688名女性，怀孕104281次。阿曼艾滋病毒感染孕妇的患病率为0.1%（1:1000），血清学阳性妊娠率为0.03%（3:10000）。在这些血清学阳性妊娠中，78.6%是已知的艾滋病毒携带者，而21.4%是新诊断病例。活产率为90.3%，9.7%导致流产。所有流产均发生在已知艾滋病毒阳性的母亲身上，她们按照国际指南进行管理。在活产中，10.7%是艾滋病毒阳性情况不明的母亲，平均孕周为39.67周，平均出生体重为3.2千克。该组中艾滋病毒母婴传播（MTCT）率为33.3%。相比之下，已知艾滋病毒阳性母亲的活产中有89.3%分娩的新生儿平均孕周为37.4周，平均出生体重为2.6千克，母婴传播率为0.0%。根据首次就诊时母亲的状况分析了分娩方式、产前、产时和产后并发症以及新生儿长期结局。
阿曼的项目已制定策略，专注于孕妇的健康以及保护新生儿免受艾滋病毒感染。严格实施预防母婴传播措施使得预防儿童感染艾滋病毒成为可能。除了禁止母乳喂养外，抗逆转录病毒疗法可显著降低艾滋病毒的垂直传播。更重要的是，所有艾滋病毒阳性孕妇都应遵循卫生部制定的预防母婴传播项目。
