Objective: To understand the incidence of adverse pregnancy outcome in HIV-infected pregnant women and influencing factors in China and provide reference for the improvement of the health status of HIV-infected pregnant women and their newborns. Methods: Based on a mother-child cohort of HIV-infected pregnant women and children (PMTCT-MC-2005) established in Guangxi Zhuang Autonomous Region, Yunnan Province and Xinjiang Uygur Autonomous Region, this study enrolled pregnant women with or without HIV infection as study subjects from January 2017 to June 2023, a total of 1 646 pregnant women (558 HIV-infected and 1 088 HIV-uninfected) were included, and 34 cases with missing data were excluded. The χ2 test was used to analyze the difference in the incidence adverse pregnancy outcome between two groups, and used logistic regression model to identify the influencing factors of adverse pregnancy outcome in HIV-infected pregnant women. Results: A total of 1 612 pregnant women were included in the study, in whom 541 were infected with HIV and 1 071 were not infected with HIV. The incidence of adverse pregnancy outcome was 18.8% (303/1 612), the incidence of adverse pregnancy outcome was 33.1% (179/541) in the HIV-infected pregnant women and 11.6% (124/1 071) in the pregnant women without HIV infection. The results of multivariable logistic regression analysis showed that the influencing factors of adverse pregnancy outcome were age <35 years at delivery (aOR=0.64, 95%CI: 0.43-0.95) compared with the age ≥35 years and the duration of antiviral treatment over 10 years (aOR=0.43, 95%CI: 0.23-0.79) compared with less than one year. Conclusions: The incidence of adverse pregnancy outcome in HIV-infected pregnant women was high in some regions of China during 2017-2023. It is necessary for HIV-infected women to get pregnancy at appropriate time based on antiretroviral treatment effect and strengthen self-care to reduce the incidence of adverse pregnancy outcome.
目的： 了解我国HIV感染孕产妇不良妊娠结局发生率，探索影响因素，为提高HIV感染孕产妇及其新生儿健康质量提供参考依据。 方法： 基于广西壮族自治区、云南省和新疆维吾尔自治区建立的HIV感染孕产妇及所生儿童母子队列（PMTCT-MC-2005），于2017年1月至2023年6月分娩的孕产妇为研究对象，纳入1 646例孕产妇（HIV感染者和未感染者分别为558和1 088例），剔除数据缺失者34例。分别采用χ2检验分析两组研究对象不良妊娠结局发生率的差异，采用logisitc回归模型分析HIV感染孕产妇不良妊娠结局的影响因素。 结果： 在研究对象1 612例孕产妇中，HIV感染者和非感染者分别为541和1 071例。不良妊娠结局发生率为18.8%（303/1 612），其中HIV感染者和非感染者分别为33.1%（179/541）和11.6%（124/1 071）。多因素logistic回归分析结果显示，分娩年龄<35岁组（相比于≥35岁组，aOR=0.64，95%CI：0.43~0.95）和抗病毒治疗时间≥10年（相比于<1年，aOR=0.43，95%CI：0.23~0.79）与不良妊娠结局的发生呈负相关。 结论： 2017-2023年我国部分地区HIV感染孕产妇不良妊娠结局的发生率较高。HIV感染孕产妇应结合抗病毒治疗效果，科学安排其妊娠间隔时间，加强自我保健，减少不良妊娠结局的发生。.