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The association between ethnicity and late presentation to antenatal care among pregnant women living with HIV in the UK and Ireland

机译：在英国和爱尔兰，艾滋病毒感染孕妇的种族与迟到产前检查之间存在关联

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UK and Ireland guidelines state that all pregnant women should have their first antenatal care appointment by 13 weeks of pregnancy (antenatal booking). We present the results of an analysis looking at the association between maternal ethnicity and late antenatal booking in HIV-positive women in the UK and Ireland. We analysed data from the National Study of HIV in Pregnancy and Childhood (NSHPC). We included all pregnancies in women who were diagnosed with HIV before delivery and had an estimated delivery date between 1 January 2008 and 31 December 2009. Late booking was defined as antenatal booking at 13 weeks or later. The baseline reference group for all analyses comprised women of "white" ethnicity. Logistic regression models were fitted to estimate adjusted odds ratios (AOR). There were 2721 eligible reported pregnancies; 63% (1709) had data available on antenatal care booking date. In just over 50% of pregnancies (871/1709), the antenatal booking date was 13 weeks of pregnancy (i.e., late booking). Women diagnosed with HIV during the current pregnancy were more likely to present for antenatal care late than those previously diagnosed (59.1% vs. 47.5%, p<0.001). Where women knew their HIV status prior to becoming pregnant, the risk of late booking was raised for those of African ethnicity (AOR 1.80; 95% confidence interval (CI) 1.14, 2.82; p=0.011). In women diagnosed with HIV during pregnancy, the risk of late booking was also higher for women of African ethnicity (AOR 2.98: 95% CI 1.45, 6.11; p=0.003) and for women of other black ethnicity (AOR 3.74: 95% CI 1.28, 10.94; p=0.016). Overall, women of African or other black ethnicity were more likely to book late for antenatal care compared with white women, regardless of timing of diagnosis. This may have an adverse effect on maternal and infant outcomes, including mother-to-child transmission of HIV.
机译：英国和爱尔兰的准则规定，所有孕妇都应在怀孕13周之前进行第一次产前检查（产前检查）。我们提出了一项分析结果，着眼于英国和爱尔兰的HIV阳性女性的母亲种族与产前晚期预订之间的关联。我们分析了《全国艾滋病毒在怀孕和儿童研究》（NSHPC）中的数据。我们将所有孕妇在分娩前被诊断出患有HIV的情况包括在内，并且预计分娩日期在2008年1月1日至2009年12月31日之间。延迟预订被定义为13周或更晚的产前预订。所有分析的基准参考人群均包括“白人”女性。拟合逻辑回归模型以估计调整后的优势比（AOR）。已报告怀孕2721例。 63％（1709）有关于产前护理预订日期的数据。在刚刚超过50％的怀孕期间（871/1709），产前预约日期为怀孕13周（即，延迟预约）。在当前怀孕期间被诊断出感染HIV的女性比以前被诊断出的女性更容易出现产前检查（59.1％对47.5％，p <0.001）。如果妇女在怀孕前就知道自己的艾滋病毒感染状况，那么非洲裔妇女的提前预订风险就会增加（AOR 1.80; 95％置信区间（CI）1.14、2.82; p = 0.011）。在怀孕期间被诊断患有HIV的女性中，非洲裔女性（AOR 2.98：95％CI 1.45，6.11; p = 0.003）和其他黑人种族的女性（AOR 3.74：95％CI）延迟预订的风险也更高。 1.28，10.94; p = 0.016）。总体而言，与非洲白人妇女相比，非洲或其他黑人种族的妇女更可能预订迟到的产前护理，而与诊断时间无关。这可能会对母婴结局产生不利影响，包括艾滋病毒的母婴传播。

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