某院2015—2017年HIV感染孕产妇的流行病学资料及妊娠结局分析

摘要

目的 探讨并分析本院2015—2017年HIV感染孕产妇的流行病学资料及妊娠结局.方法 收集本院2015年1月—2017年8月期间HIV感染孕产妇流行病学资料,分析其流行病学特征以及妊娠结局.结果 本院2015年1月—2017年8月期间筛查孕产妇总人数28 447例,其中2015年孕产妇HIV阳性检出率0.15%(15/9850),显著低于2016年和2017年的阳性检出率(P均＜0.05);2015年1月—2017年8月感染HIV的孕产妇共96例,64.58%的患者年龄集中在20～30岁,46.88%为小学及以下文化程度,41.67%为无业者,70.83%为已婚人群,70.83%为少数民族,91.67%HIV感染途径为性接触,64.58%的HIV感染孕产妇性伴侣为HIV阳性.HIV感染的孕产妇中61例(63.54%)继续妊娠并分娩,其中自然分娩4例(6.56%),剖宫产57例(93.44%);新生儿共61例,无新生儿窒息、新生儿肺炎及畸形,其中低体质量儿13例(21.31%),感染HIV新生儿5例(8.20%)均来自临产时被发现感染,且产前未服药的母亲.结论 本院2015—2017年孕产妇HIV感染率呈上升趋势,文化程度低、社会地位低、收入低的育龄期已婚孕产妇感染所占比例较高,性接触是其主要传播途径,对于有生育意愿的HIV感染孕产妇及时给予规范系统的抗病毒治疗,产后给予人工喂养,可降低HIV母婴传播风险.%Objective To explore and analyze the epidemiological data and pregnant outcomes of pregnant women infected with HIV in our hospital from 2015 to 2017. Methods The epidemiological data of HIV infected pregnant women in our hospital from January 2015 to August 2017 were collected and the epidemiological characteristics and pregnancy outcomes were analized. Results A total of 28 447 pregnant women were screened in our hospital from January 2015 to August 2017. Among them the HIV positive rate of pregnant women in 2015 was 0.15% (15/9850), which was significantly lower than that in 2016 and 2017 (P＜0.05). Ninty-six pregnant women were infected with HIV from January 2015 to August 2017. Of them 64.58% were from 20 to 30 years, 46.88% with primary school education level and below, 41.67% with unemployment, 70.83% married, 70.83% ethnic minority, 91.67% infected via sexual contact, and 64.58% with HIV positive sexual partners. Among the HIV infected pregnant women, 61 cases (63.54%) chose to continue pregnancy and childbirth, including 4 cases (6.56%) of natural childbirth and 57 cases (93.44%) of cesarean section. There were 61 newborns without neonatal asphyxia, neonatal pneumonia or abnormalities. Among them 13 newborns (21.31%) were low birth weight infants and 5 newborns (8.20%) were infected with HIV from their mothers, who were found to be infected during labor and given postpartum medication. Conclusions The HIV infection rate is rising among pregnant women in our hospital during 2015 to 2017, and the married pregnant women at childbearing age with low educational level, low social status and low income are in high proportion, and the sexual contact is the main route of transmission. Timely standardized system of antiviral therapy for HIV pregnant women with fertility desire and postpartum artificial feeding can reduce the risk of HIV mother-to-child transmission.