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埃塞俄比亚东部吉吉加和哈勒尔镇公立医院接受抗逆转录病毒治疗的育龄妇女妊娠发生率的预测因素影响:回顾性队列研究。

Effect of predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar Towns, Eastern Ethiopia: a retrospective cohort study.

机构信息

School of Public Health, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia.

School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

BMC Womens Health. 2022 Dec 26;22(1):548. doi: 10.1186/s12905-022-02135-9.

Abstract

BACKGROUND

Globally, Human Immunodeficiency Virus (HIV) is the leading cause of death in women of reproductive age and accountable for a quarter of deaths during pregnancy in sub-Saharan Africa including Ethiopia. Introduction of antiretroviral therapy to women living with HIV highly improves lifestyle and the desire to have children. A comprehensive understanding of baseline predictors of pregnancy among women receiving ART essential to reduces unintended pregnancies, appropriate care, and preventing transmission from mother to child.

OBJECTIVE

To determine the effect of baseline predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar town, Eastern Ethiopia from February 15 to march 15, 2020.

METHODS

Retrospective cohort study was conducted on randomly selected 420 HIV-infected women using data recorded from September 11, 2014, to September 10, 2019 in Jigjiga and Harar town in Eastern Ethiopia. Simple random sampling was used to select study subjects from each hospital. Data were entered to Epi data version 3.2 and exported to Stata version 14.2 for analysis. Kaplan-Meier failure, and Cox proportional hazards model were used to estimate the incidence, and to identify predictors of pregnancy respectively. Variables which were significant (P value < 0.05) in the multivariate analysis were considered independent predictors of pregnancy.

RESULTS

The overall incidence rate of pregnancy was 9.1 per 100 person-years (95% CI 7.19, 11.76). Being unadvanced HIV disease stage (AHR: 2.50; 95% CI 1.46, 4.19), having less than two children (AHR: 2.93; 95% CI 1.59, 5.40), and disclosed HIV status (AHR: 2.25; 95% CI 1.34, 3.79) were independent predictors of pregnancy.

CONCLUSION

The incidence rate of pregnancy among reproductive age women on ART was found to be considerable. Being unadvanced HIV disease stage, having less than two children, and disclosed HIV status were independent predictors of pregnancy. Thus, tailoring counseling have to be designed to enhance better pregnancy planning and consecutive health outcomes.

摘要

背景

在全球范围内,人类免疫缺陷病毒(HIV)是育龄妇女死亡的主要原因,也是撒哈拉以南非洲包括埃塞俄比亚在内的孕妇死亡的四分之一原因。为 HIV 感染者提供抗逆转录病毒治疗极大地改善了生活方式并增强了生育意愿。全面了解接受抗逆转录病毒治疗的育龄妇女怀孕的基线预测因素对于减少非意愿怀孕、提供适当的护理和预防母婴传播至关重要。

目的

确定基线预测因素对 2020 年 2 月 15 日至 3 月 15 日在埃塞俄比亚东部吉吉加和哈拉尔镇接受抗逆转录病毒治疗的育龄妇女怀孕发生率的影响。

方法

对 2014 年 9 月 11 日至 2019 年 9 月 10 日在埃塞俄比亚东部吉吉加和哈拉尔镇随机选择的 420 名 HIV 感染妇女进行回顾性队列研究。使用简单随机抽样从每家医院选择研究对象。数据输入 EpiData 版本 3.2 并导出到 Stata 版本 14.2 进行分析。Kaplan-Meier 失败和 Cox 比例风险模型分别用于估计发生率和识别怀孕的预测因素。在多变量分析中具有统计学意义(P 值<0.05)的变量被认为是怀孕的独立预测因素。

结果

总体怀孕发生率为 9.1 例/100 人年(95%CI 7.19,11.76)。未进展的 HIV 疾病阶段(AHR:2.50;95%CI 1.46,4.19)、生育子女少于两个(AHR:2.93;95%CI 1.59,5.40)和 HIV 状态披露(AHR:2.25;95%CI 1.34,3.79)是怀孕的独立预测因素。

结论

接受抗逆转录病毒治疗的育龄妇女怀孕发生率相当高。未进展的 HIV 疾病阶段、生育子女少于两个和 HIV 状态披露是怀孕的独立预测因素。因此,必须设计有针对性的咨询服务,以促进更好的妊娠计划和连续的健康结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/912f/9793559/c9521eca5bb4/12905_2022_2135_Fig1_HTML.jpg

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