摘要
目的了解1031例HIV感染孕产妇的流行病学特征,分析影响母婴传播风险的因素。方法将2010年1月1日至2018年12月31日湖南省预防艾滋病、梅毒和乙肝母婴传播信息管理系统中的1031例HIV感染孕产妇纳入研究对象,收集其人口学特征、孕产期保健和治疗情况等信息。结果1031例HIV感染孕产妇的平均年龄为(28.19±0.27)岁,文化程度普遍较低,以初中及以下为主(59.8%),经性途径感染占54.6%。分娩1031名HIV暴露儿童中,337名婴儿随访至18个月并接受HIV抗体检测,24名儿童确证为HIV感染,31名婴儿死亡。艾滋病母婴传播率从2009年的24.5%下降到2018年的6.8%。与孕前确诊感染相比,孕晚期(aOR=4.218)、产时(aOR=8.425)、产后(aOR=7.621)确诊的母婴传播风险大;与接受服务时期在孕前或孕早期相比,产时(aOR=1.318)、产后(aOR=1.512)才接受服务者确诊的母婴传播风险大;与接受随访次数≥1次相比,未接受随访(aOR=4.125)的母婴传播风险大;与母亲未用药相比,越早用药母婴传播风险越小(孕期aOR=0.171,产时aOR=0.346)。结论应重点加强对性活跃期,文化水平较低、农民、家务及待业者妇女的艾滋病知识健康教育,提高孕产妇的HIV孕早中期检测率,加强孕期随访和保健,提高HIV感染孕产妇孕期用药比例以减少艾滋病母婴传播机会。
Objective To investigate the epidemiological characteristics of 1031 HIV-infected pregnant women in Hunan Province,and to analyze the factors affecting the risk of mother-to-child transmission Methods In this study,1031 HIV-infected pregnant women were included in the information management system of mother-to-child transmission of AIDS,syphilis and hepatitis B in Hunan Province on January 1,2010 and December 31,2018.The information of their demographic characteristics,health care and treatment during pregnancy and perinatal period were collected.Results The average age of 1031 HIV-infected pregnant women was 28.19±0.27 years old,the education level was generally low,mainly junior high school or below(59.8%),and sexual transmission was the most common way of transmission(54.6%).Of 1,031 HIV-exposed children delivered,337 were followed up to 18 months of age and tested for HIV antibodies.HIV infection was confirmed in 24 children and 31 infants died.The mother-to-child transmission rate of HIV dropped from24.5 percent in 2009 to 6.8 percent in 2018.Compared with the infection diagnosed before pregnancy,the risk of mother-tochild transmission was higher in the late trimester(aOR=4.218),delivery(aOR=8.425)and postpartum(aOR=7.621).Compared with those who received services before or during the first trimester of pregnancy,those who received services at the time of delivery(aOR=1.318)and postpartum aOR=1.512)had a higher risk of mother-to-child transmission.The risk of mother-to-child transmission was higher in patients who were not followed up(aOR=4.125)than those who were followed up≥1 times.The earlier the drug was administered,the lower the risk of mother-to-child transmission(aOR=0.171 during pregnancy,aOR=0.346 at birth).Conclusion It is important to strengthen the sexually active,cultural level is low,farmers,household chores,and average women’s knowledge of AIDS health education,raise the detection rate of early and middle pregnancy,strengthen the follow-up and care during pregnancy and improve maternal pregnancy ART proportion of HIV-infected pregnant women can reduce HIV mother-to-child transmission.
作者
高洁
陈霞
吴颖岚
王华
杨敏
曾梦君
穆仪冰
秦家碧
王潇滟
GAO Jie;CHEN Xia;WU Yinglan;WANG Hua;YANG Min;ZENG Mengjun;MU Yibing;QIN Jiabi;WANG Xiaoyan(Maternal and Child Health Hospital of Hunan Province,Changsha 410008,Hunan,China;Xiangya School of Public Health,Central South University,Changsha 410008,Hunan;National Centre for Women and Children's Health,China CDC,Beijing 100081)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2021年第8期805-808,共4页
Chinese Journal of Aids & STD
基金
中国性病艾滋病防治协会·艾伯维妇幼关爱及预防母婴传播基金(PMTCT2018-004)
湖南省科技创新平台与人才计划-临床医学研究中心(2017SK4006)。
关键词
艾滋病
孕产妇
母婴传播
风险因素
AIDS
Maternal
Mother-to-child transmission
Risk factors
