A retrospective cohort study included HIV-positive pregnant women who gave birth to singletons in Chengdu between 2011 and 2020 and and HIV-negative pregnant women who delivered singletons at the Chengdu Women\'s and Children\'s Central Hospital in 2020.
Data of pregnant women living with HIV were extracted from China\'s Information System of Prevention of Mother-to-Child Transmission of HIV Management. Additionally, information for HIV-negative pregnant women was extracted from the electronic medical record system of the Chengdu Women\'s and Children\'s Central Hospital.
755 HIV-positive women and 15,094 HIV-negative pregnant women were included.
PTB and LBW rates, which were defined by gestational weeks and birth weight.
The incidences of PTB and LBW (13.51% and 14.17%, respectively) were significantly higher in the HIV-positive group compared with the HIV-negative group (6.82% and 4.65%). Propensity score matching was performed to improve comparability of the two groups, resulting in 1590 pregnancies with 558 HIV-positive and 1032 HIV-negative women in the final analysis. Conditional logistic regression was used to estimate the effect of maternal HIV status on adverse pregnancy outcomes. After propensity score matching and controlling the potential confounders, HIV infection was strongly associated with higher chances of LBW and PTB with adjusted odd ratios (95% confidence interval) of 2.53 (1.74 to 3.68) and 1.95 (1.33 to 2.85), respectively.
HIV infection was significantly associated with increased risks of PTB and LBW in Chinese pregnant women. Future studies should focus on investigating the mechanisms underlying the association between HIV infection and adverse birth outcomes, and on identifying strategies to reduce the incidence of PTB and LBW in pregnant women living with HIV.
方法:一项回顾性队列研究包括2011年至2020年在成都分娩单身的HIV阳性孕妇和2020年在成都妇女儿童中心医院分娩单身的HIV阴性孕妇。
方法:从中国预防HIV母婴传播管理信息系统中提取HIV感染孕妇数据。此外,从成都市妇女儿童中心医院电子病历系统提取HIV阴性孕妇信息。
方法:纳入了755名HIV阳性妇女和15,094名HIV阴性孕妇。
方法:PTB和LBW率,由孕周和出生体重定义。
结果:PTB和LBW的发生率(13.51%和14.17%,分别)与HIV阴性组(6.82%和4.65%)相比,HIV阳性组明显更高。进行倾向评分匹配以提高两组的可比性。最终导致1590例怀孕,558例艾滋病毒阳性和1032例艾滋病毒阴性妇女。使用条件logistic回归评估母体HIV感染状况对不良妊娠结局的影响。在倾向得分匹配并控制潜在的混杂因素后,HIV感染与LBW和PTB的较高机会密切相关,调整后的奇数比率(95%置信区间)为2.53(1.74至3.68)和1.95(1.33至2.85),分别。
结论:HIV感染与中国孕妇的PTB和LBW风险增加显著相关。未来的研究应集中于调查HIV感染与不良出生结局之间的关联机制。以及确定降低感染艾滋病毒的孕妇PTB和LBW发病率的策略。