A comparison of HIV positive and negative pregnant women at a public sector hospital in South Africa
A comparison of HIV positive and negative pregnant women at a public sector hospital in South Africa
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DOI：
10.1111/j.1365-2702.2006.01438.x
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发表时间：
2006-06-01
影响因子：
4.2
通讯作者：
Langley, G
中科院分区：
文献类型：
--
作者：
Bodkin, C;Klopper, H;Langley, G
的目标。本研究的目的是比较HIV阳性和阴性孕妇在孕产妇和新生儿结局方面的差异，为临床实践指南的制定提供信息。怀孕期间感染艾滋病毒给妇女身体应付怀孕的能力增加了负担。结果，艾滋病毒导致了与怀孕有关的问题的夸大。通过对212名分层随机选择的HIV阳性孕妇和101名匹配的HIV阴性孕妇进行回顾性记录回顾收集数据。采用双样本t检验和Fisher精确检验比较HIV阳性和阴性孕妇的母婴结局。与HIV阴性孕妇相比，HIV阳性孕妇的血红蛋白显著降低（10.85对11.48 g/dl, P = 0.001），参加产前门诊的次数显著减少（4.03对4.63,P = 0.04），体重显著减少（72.07对76.69 kg, P = 0.02），阴道分泌物异常的可能性显著增加（32.55对24.75%,P = 0.02）。HIV阳性孕妇妊高征患病率（16.98比9.90%,P = 0.06）、梅毒感染患病率（5.95比0.99%,P = 0.062）、尿路感染患病率（15.53比7.92%,P = 0.06）与HIV阴性孕妇比较差异接近统计学意义。HIV阳性孕妇比HIV阴性孕妇更容易出现宫内发育迟缓（4.72比0%，P = 0.03），分娩时间更早（37.92比38 51周，P = 0.03），分娩体重更轻（2969.98比3138.43 g, P = 0.01）。卫生部认为，南非与艾滋病毒和艾滋病有关的孕产妇发病率和死亡率高，是因为助产士在产前评估和管理艾滋病毒阳性孕妇方面缺乏公认和实用的指导方针。与临床实践相关。本研究确定了与妊娠期HIV感染相关的孕产妇和新生儿结局，并为临床实践指南的制定提供了必要的证据。
Aim. The aim of the study was to compare HIV positive and negative pregnant women with respect to maternal and neonatal outcome to inform the development of clinical practice guidelines.Background. HIV infection in pregnancy places an added burden on the physical ability of the woman's body to cope with pregnancy. As a result HIV causes an exaggeration of the problems related to pregnancy.Method. Data were collected by means of a retrospective record review conducted on 212 stratified randomly selected HIV positive and 101 matched HIV negative pregnant women. The two sample t-test and Fisher exact test were used to compare the maternal and neonatal outcomes of HIV positive and negative pregnant women.Results. HIV positive pregnant women had a significantly lower haemoglobin (10.85 vs. 11.48 g/dl; P = 0.001), attended significantly fewer antenatal clinic appointments (4.03 vs. 4.63; P = 0.04), weighed significantly less (72.07 vs. 76.69 kg; P = 0.02) and were significantly more likely to present with an abnormal vaginal discharge (32.55 vs. 24.75%; P = 0.02) than HIV negative pregnant women. The difference in the prevalence in HIV positive pregnant women of pregnancy induced hypertension (16.98 vs. 9.90%; P = 0.06), syphilis infection (5.95 vs. 0.99%; P = 0.062) and urinary tract infection (15.53 vs. 7.92%; P = 0.06) approached significance when compared with HIV negative pregnant women. HIV positive pregnant women were significantly more likely to present with intrauterine growth retardation (4.72 vs. 0%; P = 0.03), significantly more likely to deliver earlier (37.92 vs. 38 51 weeks; P = 0.03) and significantly more likely to deliver neonates weighing less (2969.98 vs. 3138.43 g; P = 0.01) than HIV negative pregnant women.Conclusion. The Department of Health attributes the high rate of HIV and AIDS related maternal morbidity and mortality in South Africa to the absence of accepted and practical guidelines for midwives' antenatal assessment and management of HIV positive pregnant women.Relevance to clinical practice. This study identifies maternal and neonatal outcomes related to HIV infection in pregnancy and provides evidence required to inform the development of clinical practice guidelines.