不同孕期HIV孕妇接受抗病毒治疗的妊娠结局分析

摘要

目的 探讨不同孕期HIV感染孕妇启用抗病毒治疗(ART))后妊娠结局情况.方法 对本院2012年至2017年50例HIV阳性且未经规范高效抗转录病毒治疗(HAART)的孕晚期孕妇(感染组)的分娩情况进行分析,并随机选取本院孕前已确诊HIV感染且孕前经ART治疗及孕中期14周后经HAART规范治疗的孕妇50例作为治疗组,同时随机选取本院未感染HIV的孕妇50例作为正常组,比较三组孕妇妊娠并发症、分娩时产后出血以及新生儿早产儿及体质量等指标.结果 感染组新生儿出生体质量(2.61±0.41) kg,治疗组(2.93±0.38)kg,正常组(3.25±0.37)kg,三组间差异均有统计学意义(均P＜ 0.05).感染组胎儿生长受限(FGR)、早产低体质量儿及新生儿窒息发生率分别为12％、18％和16％(x2=7.39、13.15、13.47,均P＜0.05);感染组产妇胎膜早破、早产儿发生率分别为20％、18％(x2=7.27、10.27,均P＜0.05);治疗组妊娠合并贫血发生率52％,明显高于感染组及正常组(x2=14.44,P＜0.05);3组产妇产后出血发生率比较,差异无统计学意义(x2=0.00,P＞0.05).结论 孕妇感染HIV会导致不良妊娠结局,孕前经ART治疗及孕中期应用HAART治疗可使HIV感染孕产妇获得较好的妊娠结局.%Objective To investigate the pregnancy outcomes of HIV pregnant women of different pregnancy stages after antivirotic treatment (ART).Methods The outcomes of 50 late pregnancy women positive in HIV and taking no highly active antiroviral therapy (HAART) from our hospital from 2012 to 2017 were analyzed;50 women who were infected by HIV and took ART before pregnancy and were treated by standard HAART after 14 weeks pregnancy at our hospital were set as a treatment group;and 50 healthy pregnant women from our hospital were set as a normal group.The incidence of pregnant complications,postpartum hemorrhage,preterm neonates,birth body weight,etc.were compared among these 3 groups.Results The birth body weight was (2.61±0.41) kg in the infection group,(2.93±0.38) kg in the treatment group,and (3.25±0.37) kg in the normal group,with statistical differences (P ＜ 0.05).The incidences of preterm low birth weight neonates,and neonatal asphyxia were 12％,18％,and 16％ in the infection group (x 2=7.39,13.15,and 13.47,all P ＜ 0.05).The incidences of premature rupture of membrane and premature infants were 20％ and 18％ in the infection group (x 2=7.27 and 10.27,P ＜ 0.05).The incidence of anemia was 52％ in the treatment group,which was higher than those in the infection group and the normal group (x 2=14.44,P ＜ 0.05).After the labor,there were no statistical differences in the incidence of postpartum hemorrhage among the 3 groups (x 2=0.00,P ＞ 0.05).Conclusions Pregnant women infectious with HIV can lead to adverse pregnancy outcomes.In the early and middle stages of pregnancy,HAART application can get a better pregnancy outcome.