周口市HIV阳性孕产妇接受预防母婴传播干预措施情况及影响因素分析

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目的了解周口市预防艾滋病母婴传播措施落实情况,评价预防效果。方法对2003-2012年发现的140例HIV阳性孕产妇及其接受预防艾滋病母婴传播干预措施进行分析。结果 140例孕产妇中,53例选择自愿人工终止妊娠,占37.9%,87例选择分娩,占62.1%,多因素Logistic回归分析显示,终止妊娠比例随着孕产妇年龄增大而增高(OR=1.084;95%CI:1.005~1.170),随产次的增多而降低(OR=0.376;95%CI:0.143~0.991),随HIV初检孕周增加而降低(OR=0.933;95%CI:0.904~0.963);87例选择分娩孕产妇64人应用抗病毒药物预防艾滋病母婴传播,用药率为73.6%,所分娩活产婴儿86名,81名儿童服用艾滋病抗病毒治疗药物,服药率94.2%,HIV初检孕周越早,母亲用药率越高(χ2=8.8,P<0.05);86名儿童18月龄HIV检测显示,HIV阳性3人,阳性率3.5%。结论周口市自2003年开展预防艾滋病母婴传播工作以来,各项措施落实到位,工作成效明显;孕期发现HIV感染,是落实预防艾滋病母婴措施的关键环节,做好母婴传播工作,必须将HIV检测工作的重点放在孕期阶段,充分发挥三级妇幼保健网络作用,提高孕期检测率,及早发现孕期HIV感染者,及早发现HIV阳性育龄妇女怀孕情况,切实做到早检测、早发现、早干预。 Objective To understand the implementation of measures to prevent mother-to-child transmission of AIDS in Zhoukou City and evaluate the prevention effect. Methods 140 cases of HIV-positive pregnant women and their interventions to prevent mother-to-child transmission of HIV were analyzed in 2003-2012. Results Among the 140 pregnant women, 53 cases chose voluntary artificial termination of pregnancy (37.9%), 87 cases chose delivery (62.1%). Multivariate Logistic regression analysis showed that the proportion of termination of pregnancy increased with the increase of maternal age (OR = (OR = 0.376; 95% CI: 0.143-0.991), which decreased with the increase of gestational weeks of HIV (OR = 0.933; 95% CI: 1.084; 95% CI: 1.005-1.170) 0.904 ~ 0.963); 87 pregnant women who chose to give birth were given 64 doses of antiviral drugs to prevent mother-to-child transmission of HIV / AIDS, with a rate of 73.6%, 86 live births and 81 children taking AIDS antiviral drugs with a medication rate of 94.2 %. The earlier the gestational age, the higher the mother’s medication rate (χ2 = 8.8, P <0.05). The HIV test of 86 children aged 18 months showed that the HIV positive rate was 3 and the positive rate was 3.5%. Conclusion Since Zhoukou started HIV / AIDS prevention and treatment of mother-to-child transmission in 2003, various measures have been put in place and the work has achieved remarkable results. The detection of HIV infection during pregnancy is a key link in implementing the measures to prevent mother-infant HIV infection. HIV testing focus on pregnancy stage, give full play to the role of three maternal and child health networks to improve detection rate during pregnancy, early detection of HIV infection during pregnancy, early detection of HIV-positive women of childbearing age pregnancy, earnestly early detection, early detection, early Intervention.
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