围产期人类免疫缺陷病毒1型传播与宫内生长：卢旺达布塔雷的一项队列研究。

Perinatal human immunodeficiency virus-1 transmission and intrauterine growth: a cohort study in Butare, Rwanda.

作者信息

Weng S, Bulterys M, Chao A, Stidley C A, Dushimimana A, Mbarutso E, Saah A

机构信息

Division of Community Medicine, Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.

出版信息

Pediatrics. 1998 Aug;102(2):e24. doi: 10.1542/peds.102.2.e24.

DOI:10.1542/peds.102.2.e24

PMID:9685470

Abstract

OBJECTIVE

To study the association of perinatal human immunodeficiency virus (HIV)-1 transmission with birth outcomes, including birth weight, gestational age, ponderal index, head circumference, and weight/head ratio.

METHODS

Data from a prospective cohort study of 627 pregnant women and their infants in Butare, Rwanda, from October 1989 until April 1994 were analyzed. A total of 318 HIV-1-infected and 309 seronegative women were enrolled during pregnancy and gave birth to 590 live singletons. Multiple linear regression modeling was used to assess the association of mother-child HIV status with several birth outcome measures.

RESULTS

Unadjusted mean birth weight of HIV- infected infants was 235 g (95% confidence interval [CI] = 94 to 376 g) less than that of HIV-uninfected infants born to HIV-positive mothers (the reference group). After adjustment for gestational age, socioeconomic factors, maternal age, parity, hematocrit, and anthropomorphic measures, mean birth weight of HIV-infected infants was 154 g (95% CI = 38 to 271 g) lower than that of the reference group. When infants born to HIV-seronegative mothers were compared with the reference group, mean birth weights did not differ. Adjusted models resulted in estimates of mean head circumference 0.6 cm smaller (95% CI = 0.2 to 1.1 cm), ponderal index 0.14 lower (95% CI = 0.05 to 0.23), weight/head ratio 3.5 lower (95% CI = 0.5 to 6.4), and gestational age 0.5 weeks shorter (95% CI = 0.1 to 0.9 weeks) for HIV-infected infants than for the reference group.

CONCLUSIONS

After adjustment for potential confounding variables, this study showed statistically significant differences in birth weight, gestational age, ponderal index, and weight/head ratio when HIV-infected infants were compared with noninfected infants born to HIV-positive mothers. HIV-1, mother-to-child transmission, Africa, intrauterine growth, birth weight, gestational age, ponderal index.

摘要

目的

研究围产期人类免疫缺陷病毒1型（HIV-1）传播与出生结局的关联，包括出生体重、孕周、 ponderal指数、头围以及体重/头围比。

方法

对1989年10月至1994年4月在卢旺达布塔雷进行的一项针对627名孕妇及其婴儿的前瞻性队列研究的数据进行分析。共有318名感染HIV-1的孕妇和309名血清学阴性的孕妇在孕期入组，并分娩出590名单胎活产婴儿。采用多元线性回归模型评估母婴HIV感染状况与多项出生结局指标之间的关联。

结果

未调整时，感染HIV的婴儿的平均出生体重比HIV阳性母亲所生未感染HIV的婴儿（参照组）低235克（95%置信区间[CI]=94至376克）。在对孕周、社会经济因素、母亲年龄、产次、血细胞比容和人体测量指标进行调整后，感染HIV的婴儿的平均出生体重比参照组低154克（95%CI=38至271克）。当将HIV血清学阴性母亲所生婴儿与参照组进行比较时，平均出生体重没有差异。调整后的模型显示，感染HIV的婴儿的平均头围比参照组小0.6厘米（95%CI=0.2至1.1厘米），ponderal指数低0.14（95%CI=0.05至0.23），体重/头围比低3.5（95%CI=0.5至6.4），孕周短0.5周（95%CI=0.1至0.9周）。