Predictors of stillbirth among HIV-infected Tanzanian women.
Predictors of stillbirth among HIV-infected Tanzanian women.
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DOI：
10.1080/00016340902835901
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发表时间：
2009
影响因子：
4.3
通讯作者：
Fawzi WW
中科院分区：
文献类型：
--
作者：
Kupka R;Kassaye T;Saathoff E;Hertzmark E;Msamanga GI;Fawzi WW
确定撒哈拉以南非洲地区艾滋病毒感染孕妇死产的孕产妇危险因素。前瞻性队列研究嵌套在微量营养素试验中。在入组时，对母亲的社会人口统计学、产科、免疫学、临床和营养变量进行了测量。每月对妇女进行门诊随访直至分娩。在泊松回归模型中确定了死产的多变量预测因素。坦桑尼亚达累斯萨拉姆市区一家三级医院的产前诊所。 N = 1,078 名妊娠 12 至 27 周的女性。死产（妊娠 28 周以上的死产）、新鲜死产和浸渍死产。在 1,017 例单胎妊娠中，有 49 例死产，每 1,000 例分娩的死产风险为 50.0 例（95% 置信区间 (CI) = 37.2, 65.6）。在已知类型的死产中，53.7% 是新鲜死产，46.3% 是浸渍死产。在多变量分析中，晚期（≥妊娠 21 周）研究进入的基线测量（相对风险 (RR) = 2.13，95% CI = 1.17, 3.87），CD3 计数≥ 1,179 个细胞/ml（RR = 2.15，95% CI = 1.16, 4.01），死产史（RR = 3.53， 95% CI = 1.30, 9.59)、初产 (RR = 3.65, 95% CI = 1.83, 7.29) 和梅毒感染 (RR = 2.06, 95% CI = 1.09, 3.88) 预测死产风险增加。较晚进入研究、文盲、死产史、初产、CD3 计数≥ 1,179 个细胞/ml、淋病感染和既往住院预测新鲜死产风险增加，而独居和梅毒感染预测浸渍死产风险增加。对已确定的社会经济、产科、免疫学和临床危险因素应用产前筛查和预防工具可能有助于降低撒哈拉以南非洲城市艾滋病毒感染妇女的高死产率。
To determine maternal risk factors for stillbirth among pregnant HIV-infected women in sub-Saharan Africa. Prospective cohort study nested within a micronutrient trial. At enrollment, maternal sociodemographic, obstetric, immunologic, clinical, and nutritional variables were measured. Women were followed through monthly clinic visits until delivery. Multivariate predictors of stillbirth were identified in Poisson regression models. Antenatal clinic in a tertiary care hospital in urban Dar es Salaam, Tanzania. N = 1,078 women enrolled between 12 and 27 weeks of gestation. Stillbirth (delivery of dead baby ≥ 28 weeks’ gestation), fresh stillbirth, and macerated stillbirth. Among 1,017 singleton pregnancies, there were 49 stillbirths, yielding a stillbirth risk of 50.0 per 1,000 deliveries (95% Confidence Interval(CI) = 37.2, 65.6). Of stillbirths with known type, 53.7% were fresh and 46.3% macerated. In multivariate analyses, baseline measures of late ( ≥ 21 weeks’ gestation) study entry (Relative Risk (RR) = 2.13, 95% CI = 1.17, 3.87), CD3 count ≥ 1,179 cells/ml (RR = 2.15, 95% CI = 1.16, 4.01), stillbirth history (RR = 3.53, 95% CI = 1.30, 9.59), primiparity (RR = 3.65, 95% CI = 1.83, 7.29), and syphilis infection (RR = 2.06, 95% CI = 1.09, 3.88) predicted increased stillbirth risk. Late study entry, illiteracy, stillbirth history, primiparity, CD3 count ≥ 1,179 cells/ml, gonorrhea infection, and previous hospitalization predicted increased risk of fresh stillbirth, while living alone and syphilis infection predicted increased risk of macerated stillbirth. Applying antenatal screening and preventive tools for the socioeconomic, obstetric, immunologic, and clinical risk factors identified may assist in reducing the high incidence of stillbirth among HIV-infected women in urban sub-Saharan Africa.
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影响因子：
3.3
作者：
Steketee, RW;Wirima, JJ;Breman, JG
通讯作者：
Breman, JG
影响因子：
3.4
作者：
Cnattingius, S;Stephansson, O
通讯作者：
Stephansson, O
影响因子：
7.7
作者：
Stephansson, O;Dickman, PW;Cnattingius, S
通讯作者：
Cnattingius, S
影响因子：
158.5
作者：
Fawzi, Wafaie W.;Msamanga, Gernard I.;Spiegelman, Donna
通讯作者：
Spiegelman, Donna
DOI：
10.1016/0020-7292(91)90532-a
发表时间：
1991-01-01
影响因子：
3.8
作者：
FERRAZ, EM;GRAY, RH
通讯作者：
GRAY, RH