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| 我国HIV感染孕产妇妊娠、分娩及婴儿喂养方式的meta分析 |
| 冯婧1,代容1,梁翼1,李乐瑜2,唐雪2,赵勇1,LeiZhang3,EricP.F.Chow3,4,5,汪洋1,曾缓1* |
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(1. 重庆医科大学公共卫生与管理学院, 重庆 400016;
2. 重庆医科大学儿科学院, 重庆 400016;
3. The Kirby Institute, University of New South Wales, Sydney, New South Wales, NSW 2010, Australia;
4. Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Vic 3053, Australia;
5. Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, Victoria, Vic 3053, Australia
*通信作者) |
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| 摘要: |
| 目的 了解2003~2011年我国人类免疫缺陷病毒(human immunodeficiency virus, HIV) 感染孕产妇的继续妊娠率、剖宫产率及其所生婴儿的人工喂养率情况,为艾滋病母婴传播的预防工作提供参考。方法 计算机检索PubMed、Web of Science、The Cochrane Library、中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据库(WanFang Data)和中国生物医学文献数据库(CBM),检索时间从建库至2013年5月,纳入国内外公开发表的关于我国HIV感染孕产妇继续妊娠、剖宫产及其所生婴儿人工喂养情况的文献。由2名研究者独立筛选文献、提取资料并评价质量。采用 Comprehensive Meta-Analysis Version2.0软件进行meta分析。采用meta回归分析方法探讨异质性的来源。结果 共检索到2 356篇文献,最终纳入61篇。Meta分析结果显示,2003~2011年,我国HIV感染孕产妇的继续妊娠率依次为67.50%[95%CI(51.73%, 80.10%)]、60.49%[95%CI(18.59%, 91.13%)]、51.80%[95%CI(28.13%, 74.68%)]、62.59%[95%CI(54.60%, 69.96%)]、64.93%[95%CI(50.18%, 77.29%)]、70.65%[95%CI(62.20%, 77.88%)]、65.66%[95%CI(59.70%, 71.16%)]、67.85%[95%CI(52.66%, 80.02%)]、75.00%[95%CI(59.46%, 85.99%)];2004~2010年HIV感染孕产妇的剖宫产率依次为26.33%[95%CI(9.41%, 55.14%)]、43.40%[95%CI(34.30%, 52.96%)]、42.57%[95%CI(35.73%, 49.70%)]、69.43%[95%CI(13.48%, 97.07%)]、46.68%[95%CI(27.27%, 67.16%)]、61.14%[95%CI(49.37%, 71.75%)]、56.60%[95%CI(36.36%, 74.85%)];2004~2010年HIV感染孕产妇所生婴儿人工喂养率除2005年为82.65%[95%CI(69.07%,91.04%)]以外,其余年份均达90.00%以上。结论 近年来我国HIV感染孕产妇继续妊娠率总体上升;剖宫产率较高,波动较大且仍在上升;HIV感染孕产妇所生婴儿人工喂养率稳定在较高水平。 |
| 关键词: 获得性免疫缺陷综合征 妊娠结局 剖宫产术 人工喂养 母婴传播阻断 meta分析 |
| DOI：10.3724/SP.J.1008.2014.01220 |
| 投稿时间：2014-02-28修订日期：2014-09-09 |
| 基金项目:重庆医科大学公共卫生与管理学院青年教师基金(XBYB2011004);中国循证卫生保健协作网项目(x7254);澳大利亚政府Endeavour奖学金(ERF_PDR_3100_2012). |
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| Pregnancy, delivery mode, and infant feeding among HIV-infected women in China: a meta-analysis |
| FENG Jing1,DAI Rong1,LIANG Yi1,LI Le-yu2,TANG Xue2,ZHAO Yong1,Lei Zhang3,Eric P. F. Chow3,4,5,WANG Yang1,ZENG Huan1* |
(1. School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China;
2. School of Pediatrics, Chongqing Medical University, Chongqing 400016, China;
3. The Kirby Institute, University of New South Wales, Sydney, New South Wales, NSW 2010, Australia;
4. Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Vic 3053, Australia;
5. Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, Victoria, Vic 3053, Australia
*Corresponding authors) |
| Abstract: |
| Objective To know about the ongoing pregnancy rate, cesarean section rate of HIV-infected pregnant women and formula feeding rate of their infants in China during 2003-2011. Methods Databases including PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database (WF) and Chinese Biological Medical Literature Database (CBM) were searched from the date of their establishment to May 2013; the literatures published in both Chinese and English reporting ongoing pregnancy, cesarean section of HIV-infected pregnant women, or formula feeding of their infants were collected. Then according to the inclusion criteria, two researchers independently screened the literature, extracted the data and assessed the quality of the included articles. Meta-analyses were conducted using the Comprehensive Meta-Analysis software (V2.0, Biostat, Englewood, New Jersey). Meta regression analysis was conducted to identify the source of heterogeneity. Results Of the total 2 356 records, 61 eligible articles were finally included. The results of meta-analysis showed that nationally, the rate of pregnancy continuation rates among HIV-infected pregnant women during 2003-2011 were 67.50%(95%CI[51.73%, 80.10%]),60.49%(95%CI[18.59%, 91.13%]),51.80%(95%CI[28.13%, 74.68%]),62.59%(95%CI[54.60%, 69.96%]),64.93%(95%CI[50.18%, 77.29%]),70.65%(95%CI[62.20%, 77.88%]),65.66%(95%CI[59.70%, 71.16%]),67.85%(95%CI[52.66%, 80.02%]),and 75.00%(95%CI[59.46%, 85.99%]), respectively; the caesarean section rates among these women during 2004-2010 were 26.33%(95%CI[9.41%, 55.14%]),43.40%(95%CI[34.30%, 52.96%]),42.57%(95%CI[35.73%, 49.70%]),69.43%(95%CI[13.48%, 97.07%]),46.68%(95%CI[27.27%, 67.16%]),61.14%(95%CI[49.37%, 71.75%]) and 56.60%(95%CI[36.36%, 74.85%]), respectively; and the formula feeding rates of exposed infants were kept at relatively high levels (90.00% above) for all the years except for 2005, which was 82.65%. Conclusion The overall rate of pregnancy continuation of HIV-infected pregnant women represents an increase in recent years in China; the cesarean section rate is high, fluctuating and increasing; the formula feeding rate of their infants keeps stable at a high level. |
| Key words: acquired immunodeficiency syndrome pregnancy outcome cesarean section formula feeding prevention of mother-to-child transmission meta-analysis |
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