2004年至2021年中国湖北省暴露于人类免疫缺陷病毒的婴儿中低出生体重的患病率及相关因素：一项回顾性队列研究

Prevalence and associated factors with low birth weight among human immunodeficiency virus exposed infants between 2004 and 2021 in Hubei, China: a retrospective cohort study.

作者信息

Liu Jinli, Wu Songjie, Zou Shi, Yan Yajun, Feng Ling, Guo Wei, Wu Mengmeng, Tang Weiming, Liang Ke

机构信息

Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China.

Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China.

出版信息

BMC Public Health. 2025 Feb 14;25(1):610. doi: 10.1186/s12889-025-21707-6.

DOI:10.1186/s12889-025-21707-6

PMID:39953495

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11827150/

Abstract

BACKGROUND

Low birth weight (LBW, < 2500 g) is an essential indicator of neonatal death and poor infant development, but data on LBW among human immunodeficiency virus (HIV)-exposed infants in China is inadequate.

OBJECTIVE

This study aimed to explore the temporal trend and factors associated with the LBW among HIV-exposed infants in Hubei province, China.

METHODS

The pregnant women living with HIV in Hubei province, China between Jan 2004 and Dec 2021 were enrolled this study. Recruited HIV-positive women were provided with consultation about preventing mother-to-child transmission (PMTCT). The intervention measures for PMTCT were provided to pregnant women and HIV-exposed infants, and the LBW and HIV status of infants were followed. Collected data included women's demographic information, HIV status of sexual partner, route of HIV transmission, HBV infection, HCV infection, syphilis infection, intrapartum CD4 count, whether received antiretroviral therapy (ART), the time of ART initiation, and ART regimens during pregnancy. Multivariable logistic regression was used to analyze factors associated with the LBW.

RESULTS

In total, 531 mothers (581 pregnancy events) and 581 infants were enrolled. The mean birth weight and LBW rate were 3075 ± 470.2 g and 8.4%, respectively. From 2004 to 2021, a significantly increased LBW rate (4.7-14.0%, P = .004) was observed. The use of protease inhibitor (PI)-based regimen (P = .04) and the exposure to ART in the first trimester (P = .01) were positively correlated with the increase of LBW rate. Exposure to ART in the first trimester (adjusted odds ratio [aOR] 3.64, 95%CI 1.29-10.27) and the second trimester (aOR 4.53, 95%CI 1.52-13.48), premature delivery (aOR 48.44, 95%CI 16.98-138.18), and infant with HIV infection (aOR 5.91, 95%CI 1.55-22.58) were predictors for LBW.

CONCLUSIONS

The significantly increased LBW rate in our study indicated that specific attention should be paid to HIV-exposed infants in China. More importantly, our study identified significant factors that can predict the risk of LBW. Interventions targeting these risk factors may prevent LBW among pregnant women living with HIV in future research and prenatal care.

摘要

背景

低出生体重（LBW，<2500克）是新生儿死亡和婴儿发育不良的重要指标，但中国人类免疫缺陷病毒（HIV）暴露婴儿的低出生体重数据不足。

目的

本研究旨在探讨中国湖北省HIV暴露婴儿低出生体重的时间趋势及相关因素。

方法

本研究纳入了2004年1月至2021年12月期间在中国湖北省感染HIV的孕妇。为招募的HIV阳性女性提供预防母婴传播（PMTCT）咨询。对孕妇和HIV暴露婴儿采取PMTCT干预措施，并跟踪婴儿的低出生体重和HIV状况。收集的数据包括女性的人口统计学信息、性伴侣的HIV状况、HIV传播途径、HBV感染、HCV感染、梅毒感染、产时CD4计数、是否接受抗逆转录病毒治疗（ART）、ART开始时间以及孕期的ART方案。采用多变量逻辑回归分析与低出生体重相关的因素。

结果

共纳入531名母亲（581次妊娠事件）和581名婴儿。平均出生体重和低出生体重率分别为3075±470.2克和8.4%。2004年至2021年期间，观察到低出生体重率显著上升（4.7%-14.0%，P=0.004）。基于蛋白酶抑制剂（PI）的方案的使用（P=0.04）和孕早期接受ART（P=0.01）与低出生体重率的增加呈正相关。孕早期（调整优势比[aOR]3.64，95%可信区间[CI]1.29-10.27）和孕中期接受ART（aOR 4.53，95%CI 1.52-13.48）、早产（aOR 48.44，95%CI 16.98-138.18）以及感染HIV的婴儿（aOR 5.91，95%CI 1.55-22.58）是低出生体重的预测因素。