Nicholas S W, Bateman D A, Ng S K, Dedyo T, Heagarty M C
Department of Pediatrics, Harlem Hospital Center, College of Physicians and Surgeons of Columbia University, New York, NY.
Arch Pediatr Adolesc Med. 1994 Aug;148(8):813-9. doi: 10.1001/archpedi.1994.02170080043007.
To determine the prevalence of human immunodeficiency virus type 1 (HIV-1) infection and its association with illicit drug use for mothers being delivered of infants at an inner-city municipal hospital.
We anonymously tested the umbilical cord blood for HIV-1 antibody of 98.1% (2971/3028) of singleton infants with birth weight greater than 500 g born during 1989 and linked the results to a maternal-infant database from which all identifying information had been removed.
Overall, HIV-1 seroprevalence was 3.3% (99/2971). Among HIV-1-seropositive mothers, 79% (78/99) gave no history of ever using injected drugs. Seropositivity for HIV-1 was independently associated with history of maternal cocaine use during pregnancy (odds ratio, 3.55; 95% confidence interval, 2.18, 5.78), history of ever using injected drugs (odds ratio, 6.02; 95% confidence interval, 3.14, 11.6), positive serologic test result for syphilis during pregnancy (odds ratio, 3.37; 95% confidence interval, 1.94, 5.88), and increasing maternal age per year (odds ratio, 1.04; 95% confidence interval, 1.00, 1.09). Voluntary testing programs failed to identify 71% (70/99) of all HIV-1-infected women. Infants placed into foster care were eight times more likely to be HIV-1 seropositive than those discharged to their mothers.
Most HIV-1-infected mothers seem to have acquired the infection via heterosexual transmission rather than via injected drug use. Associations of maternal HIV-1 infection with cocaine use, syphilis, and increasing age probably operate through behaviors that increase maternal risk of exposure to an HIV-1-infected sexual partner or, in the case of syphilis, also through biologic factors that may predispose to HIV-1 transmission. The failure of voluntary testing to identify most HIV-1-infected mothers provides a strong rationale for routine HIV-1 testing during pregnancy and in the newborn period.
确定一家市中心城市医院中分娩婴儿的母亲感染人类免疫缺陷病毒1型（HIV-1）的患病率及其与非法药物使用的关联。
我们对1989年出生体重超过500克的单胎婴儿中98.1%（2971/3028）的脐带血进行了HIV-1抗体匿名检测，并将结果与一个母婴数据库相关联，该数据库中所有识别信息均已去除。
总体而言，HIV-1血清阳性率为3.3%（99/2971）。在HIV-1血清阳性的母亲中，79%（78/99）没有曾经使用注射毒品的病史。HIV-1血清阳性与孕期母亲使用可卡因的病史（比值比，3.55；95%置信区间，2.18，5.78）、曾经使用注射毒品的病史（比值比，6.02；95%置信区间，3.14，11.6）、孕期梅毒血清学检测阳性结果（比值比，3.37；95%置信区间，1.94，5.88）以及母亲年龄每年增加（比值比，1.04；95%置信区间，1.00，1.09）独立相关。自愿检测项目未能识别出所有HIV-1感染女性中的71%（70/99）。被送入寄养机构的婴儿HIV-1血清阳性的可能性是出院回家与母亲生活的婴儿的八倍。
大多数感染HIV-1的母亲似乎是通过异性传播而非注射毒品感染的。母亲HIV-1感染与可卡因使用、梅毒和年龄增加之间的关联可能是通过增加母亲接触感染HIV-1性伴侣风险的行为起作用，或者就梅毒而言，也可能是通过可能易导致HIV-1传播的生物学因素起作用。自愿检测未能识别出大多数感染HIV-1的母亲，这为孕期和新生儿期进行常规HIV-1检测提供了有力的理由。
