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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >ADVERSE PERINATAL OUTCOMES OF HIV-1-INFECTED WOMEN IN RELATION TO MALARIA PARASITEMIA IN MATERNAL AND UMBILICAL CORD BLOOD.
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ADVERSE PERINATAL OUTCOMES OF HIV-1-INFECTED WOMEN IN RELATION TO MALARIA PARASITEMIA IN MATERNAL AND UMBILICAL CORD BLOOD.

机译：HIV-1感染妇女的不良围产期结果与母婴脐带血中的疟疾寄生虫病有关。

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摘要

Malaria infection during pregnancy increases the risk of adverse birth outcomes among HIV-infected women. The role of umbilical cord parasitemia is not well characterized. We examined the risk of adverse perinatal outcomes in relation to maternal or umbilical cord Plasmodium falciparum parasitemia among 275 HIV-infected women from Tanzania, who participated in a randomized trial of zinc supplementation during pregnancy. Maternal parasitemia (>/=1/muL) at the first antenatal visit was associated with increased risk of low birth weight < 2,500 g (adjusted relative risk [ARR] = 2.66; P = 0.01) and preterm delivery < 37 weeks (ARR = 1.87; P = 0.06). Maternal parasitemia at delivery was associated with preterm delivery (ARR = 2.27; P = 0.008), intrauterine growth retardation (ARR = 1.92; P = 0.03), and neonatal death (ARR = 3.22; P = 0.07). Cord parasitemia was associated with a large and significant increase in the risk of neonatal death (ARR = 8.75; P = 0.003). Maternal parasitemia at the first antenatal visit was strongly related to parasitemia at delivery, and the latter was associated with cord blood parasitemia. CD4 cell counts, parity, or assignment to the zinc arm (25 mg daily) were not associated with parasitemia in maternal or cord blood at delivery. Successful treatment of HIV-infected women who present to the first prenatal visit with malaria parasitemia and avoidance of reinfection are likely to decrease the risk of adverse outcomes during pregnancy and the early postpartum period. Cord blood parasitemia is a strong predictor of neonatal death. The potential effect of zinc supplementation on clinical malaria outcomes deserves future investigation.
机译：怀孕期间的疟疾感染会增加艾滋病毒感染妇女分娩不良后果的风险。脐带寄生虫病的作用尚不十分清楚。我们检查了来自坦桑尼亚的275名受HIV感染的妇女的母体或脐带恶性疟原虫寄生虫血症与围产期不良结局的风险，这些妇女参加了怀孕期间补充锌的随机试验。第一次产前检查时的母亲寄生虫血症（> / = 1 / muL）与低出生体重<2500 g（调整后的相对风险[ARR] = 2.66; P = 0.01）和早产<37周（ARR = 1.87; P = 0.06）。分娩时的孕妇寄生虫血症与早产（ARR = 2.27; P = 0.008），宫内发育迟缓（ARR = 1.92; P = 0.03）和新生儿死亡（ARR = 3.22; P = 0.07）相关。脐带寄生虫病与新生儿死亡风险大幅度显着增加有关（ARR = 8.75; P = 0.003）。第一次产前检查中的母亲寄生虫病与分娩时的寄生虫病密切相关，而后者与脐带血寄生虫病有关。分娩时CD4细胞计数，奇偶性或分配给锌臂（每天25 mg）与母体或脐带血中的寄生虫血症无关。首次出现产前就诊并患有疟疾寄生虫病并避免再次感染的成功感染HIV的妇女，很可能会降低怀孕期间和产后早期出现不良后果的风险。脐带血寄生虫病是新生儿死亡的有力预测指标。锌对临床疟疾结局的潜在影响值得进一步研究。

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