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目的了解广州孕产妇艾滋病病毒(HIV)免费普查项目,对HIV感染孕产妇孕期保健服务利用和妊娠结局的影响。方法对2011年项目推广前69名、项目推广后196名在院分娩的HIV阳性产妇的监测随访资料,进行回顾分析,比较项目实施前后产妇孕期保健服务利用情况和妊娠结局的差异。结果项目推广后,HIV感染产妇孕期产检次数超过3次的比例,比项目推广前显著升高[56.1%vs.36.2%,调整比值比(OR)为1.81,95%可信区间(CI):1.07~3.06]。调整了年龄、户籍、产次和项目推广后,与孕期无产检的HIV感染产妇相比,孕期产检≥1次的产妇,其妊娠结局为引产或死胎的风险降低了98.0%(调整OR为0.02,95%CI:0.002~0.168)。但产检次数对早产和低出生体重的风险无影响。结论政府的专项干预增加了HIV感染产妇孕期保健服务的利用率,孕期保健服务利用的增加可能进而降低了这些产妇引产或死胎的风险。
Objective To understand the free census of maternal HIV in Guangzhou and its impact on the utilization of pregnancy-related health services and pregnancy outcomes among HIV-infected pregnant women. Methods The surveillance follow-up data of 69 pre-project promotion and post-project promotion of 196 HIV-positive mothers who were hospitalized in 2011 were retrospectively analyzed. The difference in utilization of maternal health services and pregnancy outcomes before and after the project was compared. Results After the project was popularized, the proportion of HIV infected pregnant women who had more than 3 antenatal visits during pregnancy was significantly higher than that before the promotion of the project [56.1% vs.36.2%, adjusted odds ratio (OR) 1.81, 95% confidence interval (CI) 1.07 ~ 3.06]. After adjustment for age, household registration, parity and project promotion, compared with HIV-infected mothers who did not have childbirth during pregnancy, the risk of pregnancy outcome was 98.0% (OR = 0.02 , 95% CI: 0.002 ~ 0.168). However, the frequency of births has no effect on the risk of preterm birth and low birth weight. Conclusions Government-specific interventions have increased the utilization rate of antenatal care services for HIV-infected mothers and increased use of antenatal health services may further reduce the risk of these mothers being induced or stillbirths.