ABSTRACT
Objective:To analyze the prevalence of malnutrition among human immunodeficiency virus-exposed uninfected (HEU) children and to identify the associated factors in Hunan Province.Methods:All children born to human immunodeficiency virus (HIV)-infected mothers retrieved from Information System of Prevention of Mother-to-Child Transmission of human immunodeficiency virus Management (IPMTCT) in Hunan Province between July 2013 and June 2019 were included. Information including maternal demographic characteristic, maternal comorbidities/complications, anti-retroviral therapy during pregnancy, anti-retroviral prophylaxis for children, birth weight, and disease during follow-up was collected. The length and weight of children at one, three, six, nine, 12 and 18 months of follow-up time points were detected, and the prevalences of stunting, underweight, wasting and malnutrition among HEU children were evaluated. The generalized estimating equation was used to fit the logistic regression model to analyze the associated factors for malnutrition.Results:A total of 656 HEU children were finally included. The prevalences of stunting, underweight, wasting, and malnutrition among HEU children were highest at one month of age, which were 11.9%(78/656), 9.1%(60/656), 7.0%(45/656) and 21.0%(138/656), respectively. Maternal comorbidities/complications (adjusted odds ratio (a OR)=2.30, 95% confidence interval ( CI) 1.48 to 3.58), mono/dual anti-retroviral therapy during pregnancy (a OR=2.38, 95% CI 1.54 to 3.68), birth weight <2 500 g (a OR=2.66, 95% CI 1.69 to 4.21) and disease during follow-up (a OR=1.73, 95% CI 1.10 to 2.70) were the risk factors for malnutrition among HEU children (all P<0.050). Both taking zidovudine (a OR=0.60, 95% CI 0.38 to 0.94) and nevirapine (a OR=0.31, 95% CI 0.18 to 0.52) for anti-retroviral prophylaxis were the protective factors for malnutrition among HEU children (both P<0.050). Conclusions:The prevalence of malnutrition among HEU children is high. The prevalence of malnutrition is affected by maternal comorbidities/complications, anti-retroviral therapy during pregnancy, and birth weight, diseases during follow-up and anti-retroviral prophylaxis for children.
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Objective To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes.Methods Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV),Syphilis,and Hepatitis B Management in Hu'nan Province between January 2012 and December 2017 were retrospectively studied.Information of demographic characteristics,pregnancy history,and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed.According to the anti-syphilis treatment situation during pregnancy,syphilis-infected pregnant women were divided into three groups:non-treatment group,non-standardized treatment group and standardized treatment group.The incidences of adverse pregnancy outcomes among the three groups were calculated.Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes.The adjusted odds ratios (aOR) and 95％ confidence interval (CI) were calculated.Results Among 9 059 syphilis-infected pregnant women,13.9％ (1 262),31.3％ (2 834),and 54.8％ (4 963)were untreated,non-standardized treated and standardized treated patients,respectively.The incidences of total adverse pregnancy outcomes in the non-treatment,non-standardized treatment and standardized treatment groups were 25.5％ (322),20.8％ (589),and 16.2％ (806),respectively.The incidences of stillbirth in the three groups were 2.3％ (29),1.3％ (38),and 0.6％ (28),respectively;those of preterm birth were 12.6％(159),10.5％ (297),and 6.0％ (299),respectively;those of low birth weight were 6.4％ (81),6.2％(175),and 3.3 ％ (162),respectively;those of small for gestational age were 10.9％ (138),8.4％ (237),and 8.0％ (399),respectively;those of neonatal death were 1.3％ (17),1.0％ (28) and 0.3％ (15),respectively;those of neonatal asphyxia were 1.9％ (24),0.9％ (25),and 0.9％ (46),respectively;those of neonatal pneumonia were 0.6％ (8),0.9％ (26),and 0.6％ (32),respectively;those of birth defects were 2.8％(35),1.3％ (37),and 1.1％ (57),respectively;those of neonatal congenital syphilis were 2.5％ (31),2.4％ (69),and 0.8％ (42),respectively.Compared with standardized treatment group,maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.73),stillbirth (aOR =4.82),preterm birth (aOR =2.52),low birth weight (aOR =1.88),neonatal death (aOR =3.29),neonatal asphyxia (aOR =2.42) and birth defects (aOR =3.26) all P ＜ 0.01;maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.34),stillbirth (aOR =2.54),preterm birth (aOR =1.98),low birth weight (aOR =1.84),neonatal death (aOR =2.49) and neonatal congenital syphilis (aOR =1.70,P ＜ 0.05 or 0.01).Conclusions Maternal syphilis without treatment or with non-standardized treatment would increase the risks of adverse pregnancy outcomes.It is necessary to further strengthen the early screening and early treatment for syphilis-infected pregnant women,and improve the rate of standardized treatment to reduce the occurrence of adverse pregnancy outcomes.
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Objective To describe the prevalence of preterm birth (PB),low birth weight (LBW),and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province.Methods This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province,between January 2011 and December 2017.Information regarding demographic characteristics,pregnancy,antiretroviral therapy (ART),husbands/partners' relevant situation and pregnancy outcomes,among these HIV-infected pregnant women were collected and analyzed.The incidence rates on PB,LBW and SGA were calculated.Multivariate logistic regression was used to analyze the associated risk factors.Results A total of 780 HIV-infected pregnant women were enrolled.The prevalence rates on PB,LBW and SGA in HIV-infected pregnant women appeared as 7.9％ (62/780),9.9％ (77/780) and 21.3％ (166/780),respectively.Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia,hypertensive,initial time of ART ＜14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age ＞35 years old (compared to husbands/partners' age 26-30 years old) etc.,were associated with an increased risk of PB with adjusted OR as 4.59 (95％CI:1.51-13.95),4.90 (95％CI:1.56-15.46),2.40 (95％CI:1.26-4.56) and 2.29 (95％CI:1.21-4.36).For LBW,pregnancy moderate/severe anemia,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were associated with an increased risk of LBW,with adjusted OR as 3.28 (95％CI:1.13-9.54),4.37 (95％CI:1.42-13.44) and 2.68 (95％CI:1.51-4.76),respectively.For SGA,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were risk factors for SGA,with adjusted OR as 4.41 (95％CI:1.43-13.63) and 2.67 (95％CI:1.51-4.73),respectively.Conclusion Preterm birth,LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications,ART and husbands/partners' age.
ABSTRACT
Objective To describe the prevalence of preterm birth (PB),low birth weight (LBW),and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province.Methods This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province,between January 2011 and December 2017.Information regarding demographic characteristics,pregnancy,antiretroviral therapy (ART),husbands/partners' relevant situation and pregnancy outcomes,among these HIV-infected pregnant women were collected and analyzed.The incidence rates on PB,LBW and SGA were calculated.Multivariate logistic regression was used to analyze the associated risk factors.Results A total of 780 HIV-infected pregnant women were enrolled.The prevalence rates on PB,LBW and SGA in HIV-infected pregnant women appeared as 7.9％ (62/780),9.9％ (77/780) and 21.3％ (166/780),respectively.Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia,hypertensive,initial time of ART ＜14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age ＞35 years old (compared to husbands/partners' age 26-30 years old) etc.,were associated with an increased risk of PB with adjusted OR as 4.59 (95％CI:1.51-13.95),4.90 (95％CI:1.56-15.46),2.40 (95％CI:1.26-4.56) and 2.29 (95％CI:1.21-4.36).For LBW,pregnancy moderate/severe anemia,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were associated with an increased risk of LBW,with adjusted OR as 3.28 (95％CI:1.13-9.54),4.37 (95％CI:1.42-13.44) and 2.68 (95％CI:1.51-4.76),respectively.For SGA,pregnancy HBV infection and initial time of ART ＜ 14 gestational weeks were risk factors for SGA,with adjusted OR as 4.41 (95％CI:1.43-13.63) and 2.67 (95％CI:1.51-4.73),respectively.Conclusion Preterm birth,LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications,ART and husbands/partners' age.
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Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.