Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Medical Administration Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
BMJ Open. 2023 Sep 7;13(9):e071205. doi: 10.1136/bmjopen-2022-071205.
To estimate the effect of HIV infection on the risk of preterm birth (PTB) and low birth weight (LBW) among Chinese pregnancy women.
A retrospective cohort study included HIV-positive pregnant women who gave birth to singletons in Chengdu between 2011 and 2020 and and HIV-negative pregnant women who delivered singletons at the Chengdu Women's and Children's Central Hospital in 2020.
Data of pregnant women living with HIV were extracted from China's Information System of Prevention of Mother-to-Child Transmission of HIV Management. Additionally, information for HIV-negative pregnant women was extracted from the electronic medical record system of the Chengdu Women's and Children's Central Hospital.
755 HIV-positive women and 15,094 HIV-negative pregnant women were included.
PTB and LBW rates, which were defined by gestational weeks and birth weight.
The incidences of PTB and LBW (13.51% and 14.17%, respectively) were significantly higher in the HIV-positive group compared with the HIV-negative group (6.82% and 4.65%). Propensity score matching was performed to improve comparability of the two groups, resulting in 1590 pregnancies with 558 HIV-positive and 1032 HIV-negative women in the final analysis. Conditional logistic regression was used to estimate the effect of maternal HIV status on adverse pregnancy outcomes. After propensity score matching and controlling the potential confounders, HIV infection was strongly associated with higher chances of LBW and PTB with adjusted odd ratios (95% confidence interval) of 2.53 (1.74 to 3.68) and 1.95 (1.33 to 2.85), respectively.
HIV infection was significantly associated with increased risks of PTB and LBW in Chinese pregnant women. Future studies should focus on investigating the mechanisms underlying the association between HIV infection and adverse birth outcomes, and on identifying strategies to reduce the incidence of PTB and LBW in pregnant women living with HIV.
评估 HIV 感染对中国妊娠女性早产（PTB）和低出生体重（LBW）风险的影响。
这是一项回顾性队列研究，纳入了 2011 年至 2020 年期间在成都分娩的 HIV 阳性单胎孕妇和 2020 年在成都市妇女儿童中心医院分娩的 HIV 阴性单胎孕妇。
从中国预防艾滋病母婴传播信息管理系统中提取了 HIV 阳性孕妇的数据，此外，还从成都市妇女儿童中心医院的电子病历系统中提取了 HIV 阴性孕妇的数据。
共纳入 755 名 HIV 阳性孕妇和 15094 名 HIV 阴性孕妇。
早产和低出生体重率，分别定义为孕周和出生体重。
HIV 阳性组的早产和低出生体重发生率（分别为 13.51%和 14.17%）明显高于 HIV 阴性组（分别为 6.82%和 4.65%）。为了提高两组的可比性，进行了倾向评分匹配，最终分析纳入了 1590 例妊娠，其中 558 例 HIV 阳性和 1032 例 HIV 阴性。采用条件逻辑回归估计母体 HIV 状态对不良妊娠结局的影响。经过倾向评分匹配和控制潜在混杂因素后，HIV 感染与 LBW 和 PTB 的发生风险显著相关，调整后的比值比（95%置信区间）分别为 2.53（1.74 至 3.68）和 1.95（1.33 至 2.85）。
HIV 感染与中国妊娠女性的 PTB 和 LBW 风险显著相关。未来的研究应关注探讨 HIV 感染与不良出生结局之间的关联机制，并确定降低 HIV 感染孕妇 PTB 和 LBW 发生率的策略。
