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Effects of Antiretroviral Therapy and HIV Exposure in Utero on Adverse Pregnancy and Infant Outcomes:A Prospective Cohort Study in Guangzhou, China

摘要Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou,China The women were assigned to receive combination ART (cART) or mono/dual ART or no treatment.The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy,spontaneous abortion,stillbirth,preterm birth,small for gestational age (SGA)] and adverse early growth outcome (including infant death,HIV infection of mother-to-child transmission,and underweight,wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202 (35.1%) of all enrolled HIV-infected women,and 121 (31.3%) of all infants exhibited adverse effects on early growth at 4 weeks of age.The rates of adverse pregnancy outcomes,spontaneous abortion,ectopic pregnancy,stillbirth,infant death and perinatal HIV infection were higher among women not receiving ART,compared to those treated with cART or mono/dual ART (P < 0.05).However,women treated with cART had a higher rate of SGA,compared to untreated women (P < 0.05).No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART,as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival

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作者单位 Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China [1] Medical Affairs Department of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China;Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China [2] Department of Child, Adolescent and Maternal Health, School of Public Health, Capital Medical University, Beijing 100069, China [3] Department of Woman Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China [4] Institute of Child and Adolescent Health, Health Science Center, Peking University, Beijing 100191, China [5]
DOI 10.3967/bes2019.092
发布时间 2019-12-04(万方平台首次上网日期,不代表论文的发表时间)
基金项目
Transmission of HIV.Chinese Association of STD and AIDS Prevention and Control((PMTCT2018-001)) National Center for Women and Children's Health,China,CDC ((He Sheng Yuan Maternal and Infant's Nutrition and Health Program)(2018FYH008)) the National Natural Science Foundation of China((81673245,81673232))
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