Introduction:This study assessed the impact of antiretroviral therapy(ART)on stillbirth and neonatal mortality and investigated associated risk factors among Human immunodeficiency virus-positive(HIV-positive)pregnant...Introduction:This study assessed the impact of antiretroviral therapy(ART)on stillbirth and neonatal mortality and investigated associated risk factors among Human immunodeficiency virus-positive(HIV-positive)pregnant women in Yunnan,China during 2013-2022.Methods:Data from the National Information System of Integrated Prevention of Mother-to-Child Transmission of HIV,Syphilis,and Hepatitis B Program(PMTCT)were analyzed to determine stillbirth and neonatal mortality rates.Multivariate Poisson regression was employed to identify risk factors associated with stillbirth and neonatal outcomes.Results:Among 9,563 HIV-positive women with singleton pregnancies in Yunnan Province during 2013-2022,9,404(98.34%)received ART during pregnancy,while 159(1.66%)did not.There were 9,421 live births,76 stillbirths,and 66 neonatal deaths,yielding a stillbirth rate(SBR)of 8.07‰and neonatal mortality rate(NMR)of 7.01‰.The SBR was significantly lower in pregnancies where ART was used(P=0.033).Univariate analysis revealed that ART(P=0.009),ethnicity(P=0.012),and antenatal care utilization(P<0.001)were associated with stillbirth and newborn survival.Multivariate Poisson regression identified that six or more antenatal care visits as an independent predictor of survival.Conclusions:Stillbirth and neonatal mortality rates were elevated among mothers who did not receive ART during pregnancy compared to those who did.These findings emphasize the importance of ART during pregnancy,particularly since several mortality risk factors are amenable to intervention.展开更多
In China, a pilot project for the prevention of mother-to-child transmission (PMTCT) of the HIV was initiated in 2001. For the PMTCT of HIV, the Chinese government has released versions of the guidelines since 2004. I...In China, a pilot project for the prevention of mother-to-child transmission (PMTCT) of the HIV was initiated in 2001. For the PMTCT of HIV, the Chinese government has released versions of the guidelines since 2004. In 2014, the World Health Organization released guidance on global processes and criteria for the validation of elimination of mother-to-child transmission of HIV and syphilis. To promote the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B virus in China, the Chinese government updated the Guideline for PMTCT of HIV, Syphilis, and Hepatitis B in 2020 (briefly as Guideline-2020). The Guideline-2020 comprises 5 parts: goals, interventions, support measures, duties and cooperation of departments, and definition indicators for PMTCT of HIV and corresponding calculation formulas. Compared with the previous versions, the key points updated in the Guideline-2020 are that the goals are set again, and health education and promotion, the procedure of HIV testing for pregnant women, and the antiretroviral therapy regimen for HIV-positive pregnant women and antiretroviral) prophylaxis regimen for infants are all updated. The antiretroviral prophylaxis regimen as zidovudine-lamivudine-nevirapine/lopinavir/ritonavir twice per day for 6 weeks is recommended for infants at high exposure risk to HIV, whereas the third antiretroviral therapy regimen as tenofovir-lamivudine-lopinavir/ritonavir is recommended for HIV-positive pregnant women, and indicators for PMTCT of HIV and corresponding calculation formulas are defined.展开更多
文摘Introduction:This study assessed the impact of antiretroviral therapy(ART)on stillbirth and neonatal mortality and investigated associated risk factors among Human immunodeficiency virus-positive(HIV-positive)pregnant women in Yunnan,China during 2013-2022.Methods:Data from the National Information System of Integrated Prevention of Mother-to-Child Transmission of HIV,Syphilis,and Hepatitis B Program(PMTCT)were analyzed to determine stillbirth and neonatal mortality rates.Multivariate Poisson regression was employed to identify risk factors associated with stillbirth and neonatal outcomes.Results:Among 9,563 HIV-positive women with singleton pregnancies in Yunnan Province during 2013-2022,9,404(98.34%)received ART during pregnancy,while 159(1.66%)did not.There were 9,421 live births,76 stillbirths,and 66 neonatal deaths,yielding a stillbirth rate(SBR)of 8.07‰and neonatal mortality rate(NMR)of 7.01‰.The SBR was significantly lower in pregnancies where ART was used(P=0.033).Univariate analysis revealed that ART(P=0.009),ethnicity(P=0.012),and antenatal care utilization(P<0.001)were associated with stillbirth and newborn survival.Multivariate Poisson regression identified that six or more antenatal care visits as an independent predictor of survival.Conclusions:Stillbirth and neonatal mortality rates were elevated among mothers who did not receive ART during pregnancy compared to those who did.These findings emphasize the importance of ART during pregnancy,particularly since several mortality risk factors are amenable to intervention.
文摘In China, a pilot project for the prevention of mother-to-child transmission (PMTCT) of the HIV was initiated in 2001. For the PMTCT of HIV, the Chinese government has released versions of the guidelines since 2004. In 2014, the World Health Organization released guidance on global processes and criteria for the validation of elimination of mother-to-child transmission of HIV and syphilis. To promote the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B virus in China, the Chinese government updated the Guideline for PMTCT of HIV, Syphilis, and Hepatitis B in 2020 (briefly as Guideline-2020). The Guideline-2020 comprises 5 parts: goals, interventions, support measures, duties and cooperation of departments, and definition indicators for PMTCT of HIV and corresponding calculation formulas. Compared with the previous versions, the key points updated in the Guideline-2020 are that the goals are set again, and health education and promotion, the procedure of HIV testing for pregnant women, and the antiretroviral therapy regimen for HIV-positive pregnant women and antiretroviral) prophylaxis regimen for infants are all updated. The antiretroviral prophylaxis regimen as zidovudine-lamivudine-nevirapine/lopinavir/ritonavir twice per day for 6 weeks is recommended for infants at high exposure risk to HIV, whereas the third antiretroviral therapy regimen as tenofovir-lamivudine-lopinavir/ritonavir is recommended for HIV-positive pregnant women, and indicators for PMTCT of HIV and corresponding calculation formulas are defined.
