Perinatal outcomes on mortality and influencing factors among HIV-infected mothers in Sichuan province
10.3760/cma.j.cn112338-20191225-00914
- VernacularTitle:四川省HIV感染孕产妇所生围产儿死亡现状与影响因素研究
- Author:
Dan HE
1
;
Jie PU
;
Weixin LIU
;
Yan ZHANG
;
Lingling SUN
;
Xiao SONG
Author Information
1. 四川省妇幼保健院，成都 610045
- Keywords:
HIV;
Pregnant women;
Perinatal deaths
- From:
Chinese Journal of Epidemiology
2020;41(10):1686-1691
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors on perinatal mortality of pregnant women with HIV infection to reduce the mother-to-child transmission in Sichuan province.Methods:In this study, 4 786 perinatal infants of the HIV-infected pregnant women were included. Related data on perinatal epidemiology was reported by all the 183 medical and health care institutions where the HIV prevention of mother-to-child transmission program was initiated in 2005-2016. Univariate χ2 test and multivariate logistic regression methods were used to analyze the perinatal mortality outcomes and influencing factors. Results:The overall perinatal mortality rate was 25.7‰ (123/4 786) among HIV-infected pregnant women, with annual downwarding trend (trend χ2=32.220, P=0.000). Perinatal mortality rate appeared the highest ( χ2=4.130, P=0.042), with more fetal deaths and stillbirths and less early neonatal death within 7 days in Liangshan county ( χ2=29.626, P=0.000). Results from the multivariate logistic regression analysis showed that fewer pregnant numbers would contribute to the, lower perinatal mortality rate (1-2 pregnancies OR=0.417, 95 %CI: 0.184-0.943; 3-4 pregnancies OR=0.447, 95 %CI: 0.223-0.895). Perinatal deaths were more likely to be prevented if LPV/r protease inhibitor-based triple antiviral therapy was provided ( OR=0.530, 95 %CI: 0.285- 0.986) or delivery was taken place in the hospital (hospital of municipal-level and above OR=0.222, 95 %CI:0.098-0.499; county-level hospital OR=0.282, 95 %CI: 0.166-0.480; township-level hospital OR=0.134, 95 %CI: 0.031-0.586) among HIV-infected pregnant women. However, premature delivery or neonatal asphyxia would increase the risk of perinatal mortality (premature delivery OR=8.285, 95 %CI: 5.073-13.533; neonatal asphyxia OR=9.624, 95 %CI: 4.625-20.028). Conclusions:The perinatal mortality rate of HIV-infected pregnant women appeared significantly higher than that in the province or the whole country. Strategies involving LPV/r-based triple antiviral therapy, promotion of hospital delivery, reducing the incidence rates of premature deliveries and neonatal asphyxia, should be strengthened.
