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Pregnancy Outcomes in HIV-Infected Women Receiving Long-Term Isoniazid Prophylaxis for Tuberculosis and Antiretroviral Therapy

机译:接受长期异烟肼预防性治疗结核病和抗逆转录病毒疗法的艾滋病毒感染妇女的妊娠结局

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Objective. While 6- to 12-month courses of isoniazid for tuberculosis prevention are considered safe in pregnant women, the effects of longer-term isoniazid prophylaxis or isoniazid in combination with antiretroviral therapy (ART) are not established in human -immunodeficiency-virus-(HIV-) infected women who experience pregnancy during the course of therapy. Design. Nested study of pregnancy outcomes among HIV-infected women participating in a placebo-controlled, TB-prevention trial using 36 months daily isoniazid. Pregnancy outcomes were collected by interview and record review. Results. Among 196 pregnant women, 103 (52.6%) were exposed to isoniazid during pregnancy; all were exposed to antiretroviral drugs. Prior to pregnancy they had received a median of 341 days (range 1-1095) of isoniazid. We observed no isoniazid-associated hepatitis or other severe isoniazid-associated adverse events in the 103 women. Pregnancy outcomes were 132 term live births, 42 premature births, 11 stillbirths, 8 low birth weight, 6 spontaneous abortions, 4 neonatal deaths, and 1 congenital abnormality. In a multivariable model, neither isoniazid nor ART exposure during pregnancy was significantly associated with adverse pregnancy outcome (adjusted odds ratios 0.6, 95% CI: 0.3-1.1 and 1.8, 95% CI 0.9-3.6, resp.). Conclusions. Long-term isoniazid prophylaxis was not associated with adverse pregnancy outcomes, such as preterm delivery, even in the context of ART exposure.
机译:目的。虽然异烟肼预防结核病的6到12个月疗程在孕妇中被认为是安全的,但在人类免疫缺陷病毒(HIV)中尚未确定长期预防或异烟肼联合抗逆转录病毒疗法(ART)的作用-)在治疗过程中经历怀孕的感染妇女。设计。参与一项接受安慰剂对照,预防结核病试验,每天使用36个月异烟肼的HIV感染妇女的妊娠结局的嵌套研究。通过访谈和记录审查收集妊娠结局。结果。在196名孕妇中,有103名(52.6%)在怀孕期间暴露于异烟肼中。所有人都暴露于抗逆转录病毒药物。在怀孕之前,他们接受了341天(范围为1-1095)异烟肼的中位数治疗。我们在103名妇女中未观察到异烟肼相关的肝炎或其他严重的异烟肼相关的不良事件。妊娠结局为132例足月活产,42例早产,11例死产,8例低体重儿,6例自然流产,4例新生儿死亡和1例先天性异常。在多变量模型中,怀孕期间异烟肼和ART暴露均与不良妊娠结局均无显着相关(调整后的优势比分别为0.6、95%CI:0.3-1.1和1.8、95%CI 0.9-3.6)。结论长期预防异烟肼与不良妊娠结局(如早产)无关,即使在接受ART的情况下也是如此。

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