艾滋病母婴传播的影响因素分析

发布时间：2018-10-21 17:47

【摘要】：目的了解艾滋病母婴传播的危险和保护因素,为进一步完善预防艾滋病母婴传播的有关干预措施提供依据。方法采用回顾性病例对照研究方法调查河南省39个艾滋病感染状况不同县区的43例母婴传播病例,另选同地区86例未发生母婴传播的病例作为对照,采用条件Logistic回归对相关危险因素进行单因素和多因素分析。结果对不同因素进行比较,发现应用抗逆转录病毒药物的产妇,母婴传播率低于未服药产妇(22.4%vs 61.6%)(χ2=25.1,P0.01)。分娩方式中择期剖宫产产妇的母婴传播率低于顺产(30.4%vs42.1%)(χ2=5.1,P0.05)。喂养方式看人工喂养产妇的母婴传播率低于母乳和混合喂养的产妇(31.1%vs83.3%)(χ2=4.92,P0.05)。控制相关混杂因素后发现:产妇采取择期剖宫产(OR=0.25,95%CI:0.09~0.69),规范三联用药(OR=0.07,95%CI:0.02~0.28),婴幼儿采取人工喂养(OR=0.06,95%CI:0.003~1.23)可能是预防艾滋病母婴传播的保护因素,产妇产时或产后服用抗病毒药物(OR=4.38,95%CI:1.67~11.4)可能是艾滋病母婴传播的危险因素。结论艾滋病母婴传播可能受分娩方式、抗逆转录药物应用、婴幼儿喂养方式多种因素影响,应针对主要影响因素采取干预措施提高艾滋病孕产妇母婴传播服务质量。
[Abstract]:Objective to understand the risk and protective factors of mother-to-child transmission of HIV and to provide evidence for further improvement of intervention measures for prevention of mother-to-child transmission of AIDS. Methods A retrospective case-control study was conducted to investigate 43 cases of mother-to-child transmission in 39 counties and regions of Henan Province, and 86 cases without mother-to-child transmission in the same area as controls. The related risk factors were analyzed by conditional Logistic regression. Results by comparing the different factors, we found that the mother-to-child transmission rate of the parturient treated with antiretrovirals was lower than that of the untreated women (22.4%vs 61.6%) (蠂 2 / 25. 1 / P0.01). The rate of mother-to-child transmission in elective cesarean section was lower than that in normal delivery (30.4 vs 42.1%) (蠂 2 5.1P 0.05). The maternal transmission rate of artificial feeding was lower than that of breast-feeding and mixed feeding (31.1 vs 83.3%) (蠂 2 4.92 P 0.05). After controlling the related confounding factors, it was found that selective cesarean section (OR=0.25,95%CI:0.09~0.69), standardized triple drug use (OR=0.07,95%CI:0.02~0.28) and artificial feeding (OR=0.06,95%CI:0.003~1.23) may be the protective factors to prevent mother-to-child transmission of AIDS. Taking antiviral drugs (OR=4.38,95%CI:1.67~11.4) during delivery or postpartum may be a risk factor for mother-to-child transmission of HIV / AIDS. Conclusion Mother-to-child transmission of AIDS may be affected by the delivery mode, the use of antiretrovirals and infant feeding. Intervention measures should be taken to improve the service quality of mother-to-child transmission of HIV / AIDS among pregnant women and pregnant women.
【作者单位】：河南省疾病预防控制中心性病艾滋病防治研究所;
【基金】：国家科技重大专项(2012ZX10004905)
【分类号】：R512.91

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