Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter?
Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter?
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DOI：
10.1080/08035250310004261
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发表时间：
2003-08-01
期刊：
影响因子：
3.8
通讯作者：
Newell, ML
中科院分区：
文献类型：
--
作者：
Coutsoudis, A;Pillay, K;Newell, ML
目的：检查与避免母乳喂养相关的婴儿发病风险，以防止人类免疫缺陷病毒（HIV）母婴传播（MTCT）。方法：研究对象由南非艾滋病毒感染妇女所生的婴儿组成，她们正在参加维生素 A 干预试验，以预防艾滋病毒母婴传播。根据联合国艾滋病规划署的指导方针，妇女选择母乳喂养或配方奶喂养婴儿。在 1 周、6 周、3 个月以及此后每 3 个月的临床随访中记录实际喂养方式和发病率，直至 15 个月大或停止母乳喂养。根据预定的算法评估婴儿的艾滋病毒状况。结果：从未母乳喂养的 HIV 感染婴儿的结局比母乳喂养的婴儿要差；从未母乳喂养的儿童中，有 9 名 (60%) 出现过 3 次或以上发病，而母乳喂养儿童中有 15 名 (32%) 出现过 3 次或以上发病 [比值比 (OR) 4.05，95% 置信区间 (95% CI) 0.91-20.63，p=0.05]。在生命的最初 2 个月内，从未母乳喂养的婴儿（无论 HIV 状况如何）患病的可能性几乎是母乳喂养的婴儿的两倍（OR 1.91，95% CI 1.17-3.13，p = 0.006）。结论：所有从未母乳喂养的婴儿以及非母乳喂养的 HIV 感染婴儿在出生后的头几个月中都会经历显着的额外发病率。母亲、卫生工作者和政策制定者在做出所有决定时都需要考虑母乳喂养，以免抵消通过避免母乳喂养减少艾滋病毒传播所取得的成果。
Aim: To examine infant morbidity risks associated with refraining from breastfeeding where it is used in an attempt to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Methods: The population consisted of infants born to HIV-infected women in South Africa who were participating in a vitamin A intervention trial to prevent MTCT of HIV. Women chose to breastfeed or formula feed their infants according to UNAIDS guidelines. Actual feeding practices and morbidity were recorded at clinic follow-up visits at 1 wk, 6 wk, 3 mo and every 3 mo thereafter until 15 mo of age or cessation of breastfeeding. The infant's HIV status was assessed according to a predetermined algorithm. Results: HIV-infected infants who were never breastfed had a poorer outcome than those who were breastfed; 9 (60%) of those who were never breastfed had 3 or more morbidity episodes compared with 15 (32%) of breastfed children [odds ratio (OR) 4.05, 95% confidence interval (95% CI) 0.91-20.63, p=0.05]. During the first 2 mo of life, never-breastfed infants (regardless of HIV status) were nearly twice as likely to have had an illness episode than breastfed infants (OR 1.91, 95% CI 1.17-3.13, p=0.006).Conclusion: The significant extra morbidity experienced in the first few months by all never-breastfed infants and at all times by HIV-infected infants who are not breastfed needs to be considered in all decisions by mothers, health workers and policy makers so as not to offset any gains achieved by decreasing HIV transmission through avoiding breastfeeding.