【摘要】：目的分析河南省對(duì)艾滋病病毒(HIV)感染孕產(chǎn)婦,采用不同干預(yù)措施預(yù)防母嬰傳播的效果。方法采用隨訪研究的方法,利用國(guó)家預(yù)防母嬰傳播干預(yù)(PMTCT)管理信息網(wǎng)絡(luò)直報(bào)系統(tǒng),以2004年1月至2012年12月確診報(bào)告的863例HIV-1感染孕產(chǎn)婦及其所分娩的嬰兒為研究對(duì)象,收集和整理孕產(chǎn)婦接受抗反轉(zhuǎn)錄病毒藥物、安全助產(chǎn)和嬰兒喂養(yǎng)指導(dǎo)等預(yù)防艾滋病母嬰傳播干預(yù)措施的實(shí)施服務(wù)情況,收集HIV感染孕產(chǎn)婦定期隨訪和嬰兒的檢測(cè)信息,掌握嬰兒的HIV感染狀態(tài),分析干預(yù)措施對(duì)HIV母嬰傳播效果的影響。結(jié)果 HIV感染孕產(chǎn)婦所生的863名嬰幼兒中,有47名感染HIV,艾滋病母嬰傳播率為5.45%。對(duì)不同方案的藥物干預(yù)措施進(jìn)行比較,聯(lián)合、單一和未應(yīng)用抗病毒藥物的孕產(chǎn)婦,其母嬰傳播率分別為2.02%、3.16%、14.93%。在市、縣、鄉(xiāng)及以下助產(chǎn)機(jī)構(gòu)分娩的感染孕產(chǎn)婦的母嬰傳播率分別為2.56%、4.44%和20.31%。孕早期(12孕周)接受艾滋病咨詢檢測(cè)服務(wù)的產(chǎn)婦,其母嬰傳播率低于孕中晚期(≥12孕周)產(chǎn)婦(3.08%、6.47%)(χ2=4.63,P0.01),人工喂養(yǎng)嬰兒發(fā)生母嬰傳播率低于非人工喂養(yǎng)嬰兒(4.84%、14.04%)(χ2=7.05,P0.01)。多因素分析表明,產(chǎn)婦孕早期接受艾滋病咨詢檢測(cè)服務(wù)[比值比(OR)=0.24,95%可信區(qū)間(CI):0.02~1.98],產(chǎn)婦孕早期服用抗病毒藥物(OR=0.25,95%CI:0.09~0.69)、使用聯(lián)合用藥方案(OR=0.07,95%CI:0.02~0.28)、嬰幼兒采取人工喂養(yǎng)(OR=0.16,95%CI:0.07~1.03),是PMTCT的保護(hù)因素。結(jié)論艾滋病母嬰傳播的不同干預(yù)措施有效降低了艾滋病母嬰傳播水平。
[Abstract]:Objective to analyze the effect of different intervention measures on prevention of mother-to-child transmission in pregnant women infected with (HIV) in Henan Province. Methods A follow-up study was conducted on 863 women with HIV-1 infection and their babies delivered from January 2004 to December 2012, using the (PMTCT) management information network direct reporting system for national prevention of mother-to-child transmission (PMTCT). To collect and collate the implementation of the intervention measures to prevent mother-to-child transmission of AIDS, such as antiretroviral drugs, safe midwifery and infant feeding guidance, and collect information on the regular follow-up of pregnant women with HIV infection and the detection of their infants. To understand the infantile status of HIV infection and analyze the effect of intervention on HIV mother-to-child transmission. Results of the 863 infants and infants infected with HIV, 47 were infected with HIV, and the mother-to-child transmission rate was 5.45%. The rate of mother-to-child transmission was 2.02% 3.16% and 14.93% respectively for pregnant women who combined with single antiviral drugs and did not use antiviral drugs. The rate of mother-to-child transmission of infected pregnant women in midwifery institutions of cities, counties, townships and below was 2.56% and 20.31%, respectively. In early pregnancy (12 weeks of pregnancy), the mother-to-child transmission rate of pregnant women receiving AIDS counseling and testing services was lower than that of women in the second trimester (鈮，

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