Zhang Meng, Zhang Hongyan, He Junjian, Cao Yuan, Xu Feng, Shi Cannan, Xia Junfen, Qu Huimin, Hu Mengcai
Health Care Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Health Care Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
BMJ Open. 2024 Dec 15;14(12):e082805. doi: 10.1136/bmjopen-2023-082805.
HIV can greatly impact the quality of life of pregnant women and may cause adverse pregnancy outcomes, such as preterm birth (PB) and mother-to-child transmission (MTCT). The purpose of this study was to analyse the influencing factors of PB and MTCT in HIV-positive pregnant women.
HIV-positive pregnant women in Henan Province between January 2016 and December 2022 were selected for the study. Data were collected through the Management Information System for the Prevention of MTCT of HIV, syphilis and hepatitis B. Information on their demographic and clinical characteristics, treatment status and pregnancy outcomes was collected. A logistic regression model and χ automatic interaction detector (CHAID) decision tree model were used to analyse the correlation factors of PB and MTCT.
The average age of the 1073 study participants was 28.44 years, with an incidence of 11.93% for PB and 6.71% for MTCT. Hepatitis B virus or hepatitis C virus coinfection (OR=3.686, 95% CI 1.630 to 8.333) and Han nationality (OR=0.426, 95% CI 0.194 to 0.936) were risk factors for PB. Unknown HIV infection prior to pregnancy (OR=2.006, 95% CI 1.233 to 3.264) and primipara (OR=5.125, 95% CI 1.202 to 21.849) were risk factors for MTCT. The CHAID decision tree model was used to screen for the six and two influencing factors of PB and MTCT in HIV-positive women, respectively.
Early HIV testing, scientific counselling, precise maternal HIV infection assessment and targeted prevention measures can help prevent PB and MTCT in HIV-positive pregnant women.
艾滋病病毒（HIV）会对孕妇的生活质量产生重大影响，并可能导致不良妊娠结局，如早产（PB）和母婴传播（MTCT）。本研究旨在分析HIV阳性孕妇发生早产和母婴传播的影响因素。
选取2016年1月至2022年12月期间河南省的HIV阳性孕妇作为研究对象。通过艾滋病、梅毒和乙肝母婴传播预防管理信息系统收集数据。收集她们的人口统计学和临床特征、治疗状况及妊娠结局等信息。采用逻辑回归模型和χ自动交互检测（CHAID）决策树模型分析早产和母婴传播的相关因素。
1073名研究对象的平均年龄为28.44岁，早产发生率为11.93%，母婴传播发生率为6.71%。乙型肝炎病毒或丙型肝炎病毒合并感染（OR=3.686，95%CI 1.630至8.333）和汉族（OR=0.426，95%CI 0.194至0.936）是早产的危险因素。妊娠前HIV感染情况不明（OR=2.006，95%CI 1.233至3.264）和初产妇（OR=5.125，95%CI 1.202至21.849）是母婴传播的危险因素。CHAID决策树模型分别筛选出了HIV阳性女性早产和母婴传播的六个和两个影响因素。
早期HIV检测、科学咨询、精准评估孕妇HIV感染情况并采取针对性预防措施，有助于预防HIV阳性孕妇发生早产和母婴传播。
