Chu S Y, Hanson D L, Jones J L
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Obstet Gynecol. 1996 Feb;87(2):195-8. doi: 10.1016/0029-7844(95)00399-1.
To examine pregnancy rates among women infected with human immunodeficiency virus (HIV).
We used data from an ongoing survey of medical records of 3915 women who were 15-44 years of age, infected with HIV, and who received care between January 1990 and August 1994 in more than 90 clinics, hospitals, and private practices in 11 United States cities.
At enrollment, 570 (14%) of these women were pregnant. Pregnancy rates at entry varied significantly (P < .05) by age in years (15-19 [47%], 20-24 [30%], 25-29 [18%]; 30-34 [11%]; 35-39 [5%]; 40-44 [2%]); clinical status (with AIDS opportunistic illness [3%], without AIDS opportunistic illness [17%]; and race-ethnicity (white [12%], black [17%], Hispanic [8%], Asian [0%], Native American [30%]) but not by mode of exposure (injecting drug use [10%], heterosexual contact [15%], and blood transfusion [12%]). After enrollment, 5.8% of women became pregnant each year. New pregnancies were significantly less likely to occur among women with an AIDS opportunistic illness (adjusted rate ratio 0.4, 95% confidence interval [CI] 0.2-0.6), and significantly more likely to occur among women who were less than 25 years of age (adjusted rate ratio 8.3, 95% CI 5.3-13.2) and who were black (adjusted rate ratio 1.6, 95% CI 1.2-2.1). Among women who were pregnant at enrollment or during observation, 12% were pregnant more than once.
High rates of pregnancy at entry to medical care among HIV-infected women stress the importance of counseling and voluntary testing as routine obstetric-gynecologic practice. In some groups, rates of new pregnancies remain high; standard HIV care for women should include family planning services and assurance that if a woman chooses to practice contraception, contraceptives will be available and affordable.
研究感染人类免疫缺陷病毒（HIV）的女性的妊娠率。
我们使用了一项正在进行的对3915名15至44岁感染HIV女性的医疗记录调查数据，这些女性于1990年1月至1994年8月期间在美国11个城市的90多家诊所、医院和私人诊所接受治疗。
在登记时，这些女性中有570人（14%）怀孕。入组时的妊娠率因年龄（15 - 19岁[47%]，20 - 24岁[30%]，25 - 29岁[18%]；30 - 34岁[11%]；35 - 39岁[5%]；40 - 44岁[2%]）、临床状况（患有艾滋病机会性疾病[3%]，未患有艾滋病机会性疾病[17%]）和种族 - 族裔（白人[12%]，黑人[17%]，西班牙裔[8%]，亚裔[0%]，美国原住民[30%]）而有显著差异（P <.05），但不受暴露方式（注射吸毒[10%]，异性接触[15%]，输血[12%]）影响。入组后，每年有5.8%的女性怀孕。患有艾滋病机会性疾病的女性新怀孕的可能性显著降低（调整后的率比为0.4，95%置信区间[CI]为0.2 - 0.6），而年龄小于25岁的女性（调整后的率比为8.3，95%CI为5.3 - 13.2）和黑人女性（调整后的率比为1.6，95%CI为1.2 - 2.1）新怀孕的可能性显著增加。在登记时或观察期间怀孕的女性中，12%的女性不止一次怀孕。
感染HIV的女性在开始接受医疗护理时的高妊娠率凸显了咨询和自愿检测作为常规妇产科实践的重要性。在一些群体中，新怀孕率仍然很高；针对女性的标准HIV护理应包括计划生育服务，并确保如果女性选择采取避孕措施，避孕药具可得且价格合理。
