Exclusive breastfeeding in the era of AIDS.

The aim of this study was to describe breastfeeding practices, as well as what pregnant women know about breastfeeding and mother-to-child transmission (MTCT) of HIV, and explore factors associated with exclusive breastfeeding, especially in the presence of HIV/AIDS. A cross-sectional interview survey of 500 pregnant women was conducted in the Kilimanjaro region, supplemented by focus group discussions with pregnant women. Among the 309 mothers having previously breastfed, 85% had initiated breastfeeding within the first few hours postpartum, and 18% of newborns received some prelacteal food. Mean duration of breast-feeding was 23.7 months, but 46% of mothers had introduced other fluids early. Knowledge of HIV-transmission through breastfeeding was not associated with breastfeeding practices. Married women (odds ratio [OR] = .09, 95% confidence interval [CI] = .04-.24) and those having knowledge of exclusive breastfeeding (OR = .08, 95% CI = .02-.31) were the least likely to end exclusive breastfeeding early. Exclusive breastfeeding is a rare practice, and MTCT of HIV may further complicate recommendations with regard to this practice.     

Multicenter Study of Knowledge About Human Papilloma Virus and Attitudes Among Emergency Department Patients

Study ObjectiveWe sought to evaluate knowledge of human papilloma virus (HPV) and attitudes toward the HPV vaccine among emergency department (ED) patients.DesignCross-sectional survey.SettingThree Boston EDs.ParticipantsWe enrolled consecutive patients during two 24-hour periods at each site.InterventionsNone.Main Outcome MeasuresKnowledge of HPV and attitudes toward the HPV vaccine.ResultsWe enrolled 387 patients (81% of eligible). Overall, 242 (63%) participants had heard of HPV and 203 (52%) supported state-mandated vaccination. In the multivariate model, characteristics associated with lower awareness of HPV were: (1) older age (compared to age18-26-years: OR 0.45 [95%CI, 0.20–0.99] for age 27–44 years, OR 0.26 [95%CI, 0.12–0.56] for age 45–64 years, and OR 0.10 [95%CI, 0.04–0.28] for age 65 year or older), (2) black race (compared to white: OR 0.31 [95%CI, 0.15–0.64]); and (3) lower annual household income (OR 0.39 [95%CI, 0.19–0.81] for $40,000 or less). Of those people who had heard of HPV, 82% knew of its relationship to cervical cancer, but only 61% thought it was a sexually transmitted disease (STD). Support for state-mandated vaccination was higher among participants who knew that HPV was an STD (OR 2.9 [95%CI 1.7–5.0]), but was not higher among those who had heard of HPV (OR 0.64 [95%CI 0.34–1.2]) or who knew that HPV causes cervical cancer (OR 0.85 [95%CI 0.45–1.6]).ConclusionsSupport for state-mandated HPV vaccination appears to be driven more by the knowledge that HPV is an STD than by its role in cervical cancer. Awareness that HPV is transmitted through sexual activity does not decrease support for vaccination and may actually enhance it.     

Reproductive tract infections and the risk of HIV among women in Moshi,Tanzania

OBJECTIVES: The objectives of the study were to determine the prevalence of HIV and reproductive tract infections (RTIs); to compare the occurrence of RTIs among HIV-infected and non-infected women; and to assess the association of HIV with RTIs and behavioral factors among women aged 15-49 years. METHODS: A cross-sectional study was conducted in late 1999 among 382 consenting women attending three primary healthcare clinics. They were interviewed and screened for HIV-1 and RTIs. RESULTS: The prevalence of HIV-1 was 11.5%. Sixty-four percent of the women had one ongoing treatable RTI. Endogenous and sexually transmitted RTIs were higher in HIV-positive than negative women and 84% of the HIV seropositive women were co-infected with one treatable RTI. HIV was significantly associated with cervicitis (chlamydial or gonococcal) [OR = 3.2 (CI 1.1-13.2)], HSV-2 [OR = 2.6 (CI 1.3-5.1)], bacterial vaginosis [OR = 1.9 (CI 1.1-4.1)], genital warts [OR = 4.8 (CI 1.1-22.2)], and presence of vaginal discharge [OR = 2.7 (CI 1.3-5.2)]. Having more than one lifetime sexual partner, a history of infant mortality or a partner who had other wives or resided away from home > 6 months, were risk factors for HIV infection. CONCLUSION: HIV-1 and RTIs are a major public health problem among women in this population. Integration of routine screening and treatment of RTIs in the reproductive health clinics will be an important strategy to combat HIV in the area. Further, innovative behavior interventions targeting both men and women, preferably as couples are needed.     

Neonatal outcome in preterm deliveries before 34-week gestation – the influence of the mechanism of labor onset

Purpose: To evaluate neonatal outcomes in preterm infants with less than 34?weeks after spontaneous labor, preterm premature rupture of membranes (PPROM) or iatrogenic delivery and to clarify whether the mechanism of labor onset is a risk factor for adverse short-term neonatal outcome.

Methods: We performed a retrospective case-control study, which included 266 preterm newborns with less than 34-week gestation, between 2011 and 2015. Neonatal outcomes were compared according to the mechanism of labor onset. Our primary outcomes were neonatal death, sequelae on hospital discharge and a composite of these two variables (combined neonatal outcome).

Results: Compared to spontaneous preterm labor, iatrogenic preterm newborns were at increased risk of respiratory distress syndrome (RDS) [Odds Ratio (OR) 3.05 (95%CI 1.31; 7.12)], and need of exogenous surfactant administration [OR 3.87 (95%CI 1.60; 9.35)]. PPROM was associated with higher risk of neonatal sepsis [OR 12.96 (95%CI 1.18; 142.67)]. There were no differences regarding the combined outcome for iatrogenic [OR 0.94 (95%CI 0.33; 2.71)] or PPROM [OR 1.11 (95%CI 0.35; 3.49)] groups.

Conclusions: In our study, the different mechanisms of labor onset are associated with different neonatal outcomes. Iatrogenic preterm birth was associated with an increased risk of RDS and a higher need of exogenous surfactant administration than spontaneous group. The rate of neonatal sepsis was significantly higher in PPROM group along with a higher prevalence of histological chorioamnionitis.     

New mothers' knowledge and attitudes about perinatal human immunodeficiency virus infection

OBJECTIVES: To assess new mothers' attitudes toward perinatal human immunodeficiency virus (HIV) testing, their knowledge about perinatal HIV, and their trust of government and scientists. METHODS: In a cross-sectional survey of 1362 postpartum women at four United States locations in 1997, a standardized interview was administered to new mothers 24-48 hours postpartum to determine their HIV test acceptance, attitudes, and knowledge. RESULTS: Seventy-five percent of women who were offered HIV tests reported being tested. Although 95% of women were aware of perinatal HIV transmission, only 60% knew that HIV can be transmitted through breast-feeding, and only 51% knew of medication to prevent perinatal transmission. Eighty-four percent of women thought that all pregnant women should be tested for HIV, and 60% thought that prenatal HIV testing should be legally mandated. Twenty percent of women indicated mistrust of government and scientists regarding origins of HIV and potential cures for AIDS. Knowledge about perinatal transmission was unrelated to receipt of prenatal HIV tests. When other factors were controlled for, mistrust was not significantly associated with getting tested. CONCLUSION: Incomplete knowledge of prevention of perinatal HIV transmission and mistrust were prevalent among new mothers. Knowledge deficits or mistrust did not appear to reduce reported prenatal test rates, but our data suggest that future public health efforts need to educate women about methods of preventing perinatal HIV transmission and at enhancing their trust in the public health system.     

Are public antenatal clinics in Blantyre, Malawi, ready to offer services for the prevention of vertical transmission of HIV?

At least 100% of the adult population in Malawi is infected with HIV and vertical transmission is a major mode of transmission. Currently, there are plans to provide widespread antiretroviral therapy to prevent mother to child transmission of HIV. This study was conducted to describe the perceptions of midwives towards selected issues regarding prevention of mother to child transmission of HIV in eleven public health centres in Blantyre, Malawi. A cross-sectional study using a self-administered questionnaire incorporating both open-ended and closed-ended questions was used. Twenty seven midwives participated in the study. Less than half (40.7%), of them reported working at a baby friendly hospital initiative health facility, while 96.3% reported that they would advise an HIV infected woman to breastfeed her infant. HIV prevention messages were reportedly offered routinely by 77.8% of the respondents, but only 22.2% reported that their clinics offered condoms to pregnant women. Also, only 37.0% reported offering routine STI screening, while 37.0% of the midwives would support antenatal women being accompanied by their male partners Majority (81.2%) said that women who know they are HIV infected should not become pregnant, while 37.0% reported that they would be uncomfortable to assist in the delivery of an HIV infected woman. There was lack of appropriate clinic space and sterile gloves for the proper delivery of maternity services. Midwives in Malawi need training, supervision and other support to provide adequate health care services to antenatal women.     

Severe anemia in pregnancy in rural Ghana: a case-control study of causes and management

BACKGROUND: Various factors contribute to severe anemia in pregnancy in low-income countries. This study assesses which of these are of importance in rural Ghana, and evaluates management. METHODS: Prospective case-control study in two (sub)district hospitals in rural Ghana among 175 severely anemic pregnant women (Hb < 8.0 g/dl), receiving a comprehensive treatment package; and 152 non-anemic pregnant women (Hb > or = 10.9 g/dl), giving birth at the study hospitals, matched for age and parity. Evaluated characteristics were need for treatment for urinary tract infection and schistosomiasis; sickle cell and HIV status; antenatal care characteristics; and Hb increase after treatment. Statistical analysis included Chi square test and general linear modeling. RESULTS: Associated with severe anemia were multiple pregnancy (OR 8.9; 95%CI 1.1-71.0), urinary tract infection (OR 6.2; 95%CI 3.5-11.0), residence outside study (sub)district (OR 2.7; 95%CI 1.7-4.3), body mass index < 20.0 (OR 2.0; 95%CI 1.2-3.4), and less than 4 antenatal clinic visits (OR 1.9; 95%CI 1.2-3.0). No association was found with sickle cell or HIV status, schistosomiasis treatment, blood loss in pregnancy, or gestational age at antenatal care registration. After treatment, mean Hb in the severe anemia group increased by 3.2 g/dl, significantly more than in the control group (0.2 g/dl; p<0.001). Modeling showed that the number of antenatal visits and the lowest Hb together explained approximately 25% of the variability in Hb prior to childbirth among women with severe anemia. CONCLUSIONS: Treatable causes contribute considerably to severe anemia in pregnancy in low-income countries. Even with limited resources, a substantial increase of Hb can be achieved.     

KAP Study on HIV/AIDS Among Antenatal Women Attending Central Referral Hospital of North East India

Background

This study was conducted to determine whether antenatal mothers in Sikkim have adequate knowledge about awareness, attitude, and preventive practices regarding HIV infection.

Methods

Cross-sectional study using structured questionnaire. 220 Antenatal mothers attending the outpatient department of Central Referral Hospital of Sikkim were taken for the study for a period of 1 year from April 2011 to April 2012. Questionnaire form filled by pregnant women during their first antenatal visit was the source of data for this study. Systematic sampling technique was used where every alternate pregnant women registering for ANC visit were voluntarily recruited into the study.

Results

2.27 % (5) women had not heard about HIV. 84 % (38) women had the knowledge that HIV was related to STI, while 50 % (110) did not. Television was the best method of increasing the knowledge (48 %). 68 % (150) of the women were aware about mother-to-child transmission (MTCT) of HIV during antenatal period. Only 2.66 % (6) women knew that HIV can be transmitted to child through breast milk. 90 % (198) knew that HIV is spread by having unsafe sex, 48 % (106) women knew using condoms would protect against it. 69.4 % (153) women wanted partner testing, and 84 % (185) of women consented that all pregnant women should be tested for HIV.

Conclusions

The current study revealed high levels of knowledge, positive attitude, and preventive practices regarding HIV; however, this population lacked knowledge about MTCT and its prevention.

     

Evaluation of an Emergency Prevention Program for Mother to Child Transmission of HIV in British Columbia

IntroductionThe objective of this study was to evaluate a provincewide program designed to identify HIV infection accurately and to prevent mother to child transmission among high-risk pregnant women of unknown serostatus.MethodsBetween 2000 and 2007, 347 high-risk women were identified through the Prevention of Mother to Child Transmission (PMTCT) program implemented in 27 hospitals across British Columbia. Rates of HIV transmission and details of the implementation of prophylaxis kits were assessed.ResultsOf the 346 high-risk mother-infant pairs identified and included in the provincial program, 35.4% of the mothers and 95.7% of infants received antiretroviral therapy for prevention of vertical transmission. Of 309 pairs who subsequently underwent HIV testing, five mothers were found to be HIV positive, an infection rate of 16.2/1000 in this cohort; the overall rate in BC is 0.68/1000 births. One of the five infants born to an HIV positive mother was infected with HIV.DiscussionThe program was successful in identifying a subgroup of pregnant women at increased risk of HIV infection; however, mother to child transmission occurred in one of five cases (20%). To reduce the risk of mother to child HIV transmission in BC to the lowest possible level, additional strategies such as increasing uptake of prenatal screening and point-of-care testing in labour and delivery may need to be explored.     

The HIV infection in pregnant women in French Guiana

OBJECTIVE: The aim of this study is to analyse the characteristics of HIV pregnant women in French Guiana then to evaluate the HIV mother to child transmission rate (MTCT) and determine the pronostic factors associated with MTCT. PATIENTS AND METHOD: An epidemiological study has been led including all deliveries in French Guiana from January 1998 to December 2000. For each case a standardized questionnaire has been gathered including epidemiological, clinical and biological data and an univariate analysis has been realized. A hundred and forty-eight women have been included in the study among 135 women came for delivery. RESULTS: The factors associated with increased MTCT in our study were no antiretroviral therapy before delivery, the lack of follow-up during pregnancy and no antiretroviral therapy in children. The HIV mother to child transmission rate was 6,5% despite the availability of antiretroviral therapies. DISCUSSION AND CONCLUSION: This rate may be explained by the difficulties of follow-up in HIV infected women. Much more needs to be done to improve access to care for women coming from foreign countries. This may be indispensable to reduce the HIV mother to child transmission rate in French Guiana.     

单、双胎妊娠并发子痫前期不良妊娠结局的荟萃分析

目的探讨单、双胎妊娠并发子痫前期的孕妇与围产儿不良结局发病率差异。 方法检索PubMed、Web of Science、中国生物医学文献数据库、中国学术文献总库、万方和维普中文数据库中2000年1月至2017年12月国内外发表的关于单、双胎妊娠并发子痫前期妊娠结局的研究。采用RevMan 5.3与Stata 12.0软件对资料进行荟萃分析,采用OR值及相应的95%CI评价不良结局与双胎妊娠并发子痫前期的相关性。 结果纳入10篇文献,共692例双胎妊娠合并子痫前期,3101例单胎妊娠合并子痫前期。双胎妊娠合并子痫前期组发病率高于单胎妊娠合并子痫前期：胎盘早剥OR＝2.16,95%CI为1.40～3.36;产后出血OR＝2.90, 95%CI为2.03～4.15;心功能衰竭OR＝3.73, 95%CI为2.10～6.63 ;肺水肿OR＝2.76, 95%CI为1.04～7.27;剖宫产OR＝2.27, 95%CI为1.58～3.26;胎膜早破OR＝2.99, 95%CI为1.64～5.47;早产OR＝6.24,95%CI为4.16～9.38,新生儿重症监护病房转入率OR＝2.33, 95%CI为1.66～3.26。 结论双胎妊娠合并子痫前期的不良妊娠结局包括胎盘早剥、产后出血、心功能衰竭、肺水肿、剖宫产、胎膜早破、早产和新生儿重症监护病房转入的发病率比单胎妊娠合并子痫前期高。     

Maternal and fetal outcome after severe anemia in pregnancy in rural Ghana

BACKGROUND: Anemia in pregnancy contributes to poor outcome for mother and child in low-income countries. This study analyzes adverse maternal and fetal outcome after severe anemia in pregnancy in rural Ghana. METHODS: A cohort study in two (sub)district hospitals, including 157 pregnant women exposed to severe anemia (Hb < 8.0 g/dl) and 152 nonexposed pregnant women (Hb > or = 10.9 g/dl), matched for age and parity strata. Adverse outcomes analyzed were postpartum hemorrhage, need for blood transfusion, maternal mortality, low birth-weight, and perinatal mortality. RESULTS: Compared to nonexposed women, exposed women had an increased risk of maternal death (5/157 versus 0/152). Fetal outcome did not significantly differ between the study groups, although perinatal mortality was increased with exposure to Hb < 7.0 g/dl (OR 3.1; 95% CI 1.0-9.4), and low birth-weight was increased with exposure to Hb < 6.0 g/dl (OR 2.5; 95% CI 1.2-5.4). Overall fetal outcome was significantly better when hemoglobin prior to childbirth was at least 8.0 g/dl (OR 3.9; 95% CI 1.6-9.6), body mass index at least 20 kg/m2 (OR 2.8; 95% CI 1.5-5.3), and number of antenatal visits at least 4 (OR 2.0; 95%CI 1.1-3.7). CONCLUSIONS: Severe anemia in pregnancy results in relatively poor maternal and fetal outcome. Apparently maternal risks increase prior to fetal risks. In order to improve maternal and fetal outcome, it is recommended that district hospitals in low-income countries make prevention, early diagnosis, and treatment of severe anemia in pregnancy a priority.     

Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria

ABSTRACT: BACKGROUND: Malaria infection in pregnancy is a major risk factor for maternal and child death, and substantially increases the risk of miscarriage, stillbirth and low birthweight. The aim of this study therefore is to assess the prevalence and determinants of Intermittent preventive treatment of Malaria [IPTp] utilization by pregnant women in a rural town in Western Nigeria. METHODS: This study is an analytical cross-sectional study. All pregnant women that were due for delivery and were attending the three primary health care center in Sagamu town, Nigeria within a 2 months period were recruited into the study. A semi- structured questionnaire was used to collect relevant information. RESULTS: A total of 255 pregnant women were recruited into the study. The mean age of respondents was 28.07 +/- 5.12 years. The mean parity and booking age was 2.7 +/- 1.67 and 4.42 +/- 1.7 months respectively. The prevalence of Malaria attack in the last 3 months was 122(47.8%). Only 107/255 (40.4%) practice IPTp for malaria prevention during the current pregnancy, with only 14.6% of them taking the second dose during pregnancy as recommended. Chloroquine [27.1%] was the most frequently used medication for the treatment of Malaria in Pregnancy. Early booking age [OR = 1.11, C.I = 0.61-2.01], adverse last pregnancy outcome [OR = 1.23, C.I = 0.36-4.22], and parity [OR = 1.87, C.I = 0.25-16.09] were not statistically significantly associated with IPTp utilization. The only predictor of IPTp use was the knowledge of prophylaxis for malaria prevention [OR = 2.47, C.I = 1.06-3.52] using multivariate analysis. CONCLUSION: The study concludes that most women who attend ANC in rural areas in Nigeria do not receive IPTp as expected. A major determinant of utilization of IPTp among the study population was the knowledge of prophylaxis for malaria prevention. This study highlights the importance of health education of the pregnant women in increasing IPTp uptake despite the regular drug stock out at the facility level in rural areas in low resource countries.     

Predictors of unknown HIV serostatus at the time of labor and delivery in Kampala,Uganda

Objective

To determine factors associated with an unknown HIV serostatus among pregnant women admitted in labor to Mulago Hospital, Kampala, Uganda.

Methods

In total, 665 pregnant women admitted to Mulago Hospital were interviewed about their sociodemographic characteristics, obstetric history, access to prenatal care, fears regarding HIV testing, and knowledge about modes of mother-to-child-transmission (MTCT). Knowledge of the HIV serostatus was assessed by self-report and verified by prenatal card review.

Results

The prevalence of unknown HIV serostatus at the time of labor was 27.1%. Factors associated with an unknown HIV serostatus included high parity (odds ratio [OR] 1.9; 95% confidence interval [CI], 1.16–3.14), preterm delivery (OR 2.60; 95% CI, 1.06–6.34), prenatal care at a private clinic (OR 12.87; 95% CI, 5.68–29.14), residence more than 5 km from the nearest prenatal clinic (OR 2.86; 95% CI, 1.18–17.9), high knowledge about MTCT (OR 0.25; 95% CI, 0.07–0.86), and fears related to disclosing the test result to the partner (OR 3.60; 95% CI, 1.84–7.06).

Conclusion

The high prevalence of unknown HIV serostatus among women in labor highlights the need to improve accessibility to HIV testing services early during pregnancy to be able to take advantage of antiretroviral therapy.     

Using the Rapid HIV Test to Rescreen Women in the Third Trimester of Pregnancy

Antiretroviral therapy during pregnancy in HIV‐infected women has dramatically reduced the rate of mother to child HIV transmission in the United States. National guidelines strongly recommend universal HIV testing of all pregnant women with repeat screening in the third‐trimester in high‐risk populations. To determine patient attitudes towards third‐trimester rescreening, a convenience sample was recruited during routine prenatal visits at an urban clinic and participants were surveyed to determine attitudes about HIV third‐trimester retesting, acceptability of the rapid HIV testing, condom use, and knowledge of partner's HIV status during pregnancy. Participants were offered a third‐trimester rapid HIV retest with the option to decline the test. Eighty pregnant women participated; 95% agreed to be retested with a rapid HIV test, 100% received immediate HIV results, and 91% reported that the rapid test was less stressful than conventional testing. There were no seroconversions. Although 35% did not know their partner's HIV status, 57% of these women reported never using condoms during pregnancy. There was a significant association between reported stage of behavior change and reported likelihood of using condoms. We found that rescreening with the rapid HIV test in the third trimester of pregnancy was well accepted and is important to prevent perinatal HIV transmission.     

Self-disclosure of HIV serostatus in recently diagnosed patients with HIV in South Africa

Failure of people living with HIV/AIDS to disclose their HIV serostatus can place their sexual partners at risk. The current study examined HIV serostatus disclosure and its relationship to risky sexual behaviours in 69 sexually active, heterosexual, married (62%) or cohabiting (38%) patients recently diagnosed as HIV positive. Results show that 78% had not disclosed their HIV serostatus to their sexual partners and 46% had no knowledge of their sexual partner's serostatus. Compared to those who disclosed their serostatus, those who did not disclose were more likely to be male (chi2 = 7.02, p = 0.00), to have not used a condom during their last sexual encounter (chi2 = 29.64, p = 0.000), to have used alcohol heavily before sex (chi2 = 6.79, p = 0.00), to have multiple sexual partners (t = 3.01, p = 0.05), and to have engaged more frequently in sexual intercourse in the six months preceding the study (t = 8.21, p = 0.00). Logistic regression analysis show that being in a married relationship (OR = 0.86, 95% CI = 0.65, 1.15), being male (OR = 1.48, 95% CI = 0.24, 1.99), having more than two multiple partners (OR = 2.03, 95% CI = 1.11, 3.68) and non-use of condom at last sex (OR = 1.53, 95% CI = 0.83, 1.88) were significantly associated with non-disclosure of HIV serostatus. Preventive strategies among HIV-positive patients should place emphasis on the management of self-disclosure and its importance in safe sexual behaviour.     

Women's knowledge about treatment to prevent mother-to-child human immunodeficiency virus transmission

OBJECTIVE: To provide national estimates of knowledge about treatments available to reduce mother-to-infant human immunodeficiency virus (HIV) transmission among U.S. women of childbearing age. METHODS: We used data from 55712 women aged 18 to 44 years who responded to questions on antiretroviral treatment in the 2001 Behavioral Risk Factor Surveillance System. We obtained the percentage of women who correctly answered a question on treatment to prevent mother-to-child transmission of HIV and determined factors independently associated with such knowledge using a multiple logistic regression model. RESULTS: Overall, the percentage of women who correctly stated that treatment existed to help prevent mother-to-child transmission of HIV was 58.6% (95% confidence interval 57.9, 59.3). In the multiple logistic regression model that controlled for sociodemographics, having correct knowledge about treatment to prevent mother-to-child HIV transmission was independently associated with being black, younger age (18-34 years), college level education, and having been tested for HIV. Current pregnancy was not an independent predictor of having knowledge about the availability of treatment to prevent mother-to-child transmission. CONCLUSION: Among US women of childbearing age, just over one half had correct knowledge of effective perinatal HIV prevention strategies. Increasing the awareness of these treatments may lead to greater uptake of HIV testing among pregnant women.     

Current guidelines on management of HIV-infected pregnant women: impact on mode of delivery

OBJECTIVE: To evaluate acceptance, feasibility and difficulties in the application of a policy of vaginal delivery in selected cases in HIV-infected women. STUDY DESIGN: HIV-infected women delivering March 2002 to December 2004 and enrolled in a prospective observational study in a University hospital tertiary care center were included. A vaginal delivery was not considered if labor before 36 weeks of pregnancy, preterm premature rupture of membranes, on non-highly active antiretroviral therapy (HAART) or viral load >1000copies/mL. Main outcome measures were mode of delivery, prematurity, acceptance of vaginal delivery and mother-to-child transmission of HIV infection. RESULTS: The study included 91 pregnancies, with a total of 95 fetuses. Eighty percent (n=73) of women knew their HIV infection status before becoming pregnant and 57 (63%) were on HAART at conception. Median gestational age at delivery was 37 weeks (range 22-41). Twelve women delivered a live-born before 36 weeks, all with a caesarean section. Among 74 women who reached 36 weeks gestation, 47 (64%) met the pre-established criteria for vaginal delivery, of whom 21 (45%) delivered vaginally. The most common reason for not having a vaginal delivery was the woman's request for a caesarean section. No cases of HIV vertical transmission occurred (0/90, 95% CI 0-4.02%). CONCLUSION: Recommending vaginal delivery among HIV-infected women in selected cases was well accepted, particularly once the policy became established. Nevertheless, a high proportion of HIV-infected women will continue to require caesarean section delivery.     

妊娠前BMI与子痫前期发生及临床特征的关系

目的:探讨妊娠前体质指数（BMI）与子痫前期（PE）发生及临床特征的关系。方法:收集2017年7月1日至2019年12月31日于南方医科大学附属深圳妇幼保健院诊断为宫内妊娠,孕周为6~8周 +6,排除有基础性疾病和病历资料不完整者,共计42 427例孕妇,其中诊断为PE者659例。依据孕前BMI分为低体重组...