Iordache Madalina Daniela, Meca Daniela Catalina, Cirstoiu Monica Mihaela
Department of Obstetrics and Gynaecology, University Emergency Hospital Bucharest, Doctoral School of Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Department of Obstetrics and Gynaecology, University Emergency Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Cureus. 2024 May 3;16(5):e59568. doi: 10.7759/cureus.59568. eCollection 2024 May.
Background Adverse pregnancy outcomes in women with human immunodeficiency virus (HIV) infection remain significantly increased. Untreated maternal infection primarily leads to fetal complications, such as intrauterine growth restriction, stillbirth, or preterm birth. Concerning both maternal and fetal complications that can appear in pregnancy associated with HIV infection, the purpose of the study was to determine fetal and maternal demographic characteristics and the correlation between blood count parameters and poor fetal prognosis. Methods We conducted a quantitative study utilizing document review as the data collection method. This study encompassed a cohort of nine HIV-positive pregnant women who delivered at the Obstetrics and Gynecology Department of the University Emergency Hospital in Bucharest from January 1, 2021, to December 31, 2023. A comparative cohort of nine healthy pregnant women who delivered during the same period in the same facility was selected using stratified random sampling. We examined maternal and fetal demographic parameters and neonatal outcomes, reporting them to paraclinical laboratory data. Results The incidence of pregnancy-related HIV infections was 0.16%. The mean age of patients in the selected group was 29.88 ± 5.53. There was no statistically significant correlation between maternal clinical and paraclinical parameters in the HIV-positive and HIV-negative groups. Although there was a slightly negative difference in the fetal weight at birth, the 1-min APGAR (appearance, pulse, grimace, activity, and respiration) score, and the intrauterine growth restriction between the two groups, there was a statistically significant association between admission to the neonatal intensive care unit (NICU) and the neonates from HIV-positive pregnancies. In our study, we observed preterm deliveries in 22.22% of cases, and we did not record any stillbirths. The 1-min APGAR score was correlated with the value of leukocytes in peripheral blood. Vertical transmission was established to be 11.11% independent of maternal blood count parameters. Conclusion HIV infection during pregnancy leads to a higher risk of admission to the NICU. Fetal leukocytosis is indicative of a lower 1-min APGAR score. The primary emphasis of therapeutic intervention during pregnancy should center on vigilant monitoring of maternal viral load and the timely administration of antiretroviral therapy to enhance fetal outcomes.
背景 感染人类免疫缺陷病毒(HIV)的女性不良妊娠结局仍显著增加。未经治疗的母体感染主要导致胎儿并发症,如宫内生长受限、死产或早产。考虑到与HIV感染相关的妊娠中可能出现的母体和胎儿并发症,本研究的目的是确定胎儿和母体的人口统计学特征以及血细胞计数参数与不良胎儿预后之间的相关性。方法 我们采用文献回顾作为数据收集方法进行了一项定量研究。本研究纳入了2021年1月1日至2023年12月31日在布加勒斯特大学急诊医院妇产科分娩的9名HIV阳性孕妇队列。使用分层随机抽样选择了同期在同一机构分娩的9名健康孕妇作为对照队列。我们检查了母体和胎儿的人口统计学参数以及新生儿结局,并将其与临床实验室数据进行报告。结果 妊娠相关HIV感染的发生率为0.16%。所选组患者的平均年龄为29.88±5.53。HIV阳性和HIV阴性组的母体临床和临床实验室参数之间无统计学显著相关性。尽管两组之间出生时胎儿体重、1分钟阿氏(外观、脉搏、鬼脸、活动和呼吸)评分以及宫内生长受限存在轻微负差异,但HIV阳性妊娠新生儿入住新生儿重症监护病房(NICU)之间存在统计学显著关联。在我们的研究中,我们观察到22.22%的病例为早产,未记录任何死产。1分钟阿氏评分与外周血白细胞值相关。垂直传播率为11.11%,与母体血细胞计数参数无关。结论 孕期HIV感染导致入住NICU的风险更高。胎儿白细胞增多表明1分钟阿氏评分较低。孕期治疗干预的主要重点应集中在密切监测母体病毒载量并及时给予抗逆转录病毒治疗以改善胎儿结局。