Hiv-infected Maternal Death In Children Born Status And Influencing Factors

[BACKGROUND]AIDS is a major global public health problem that is the serious threat to the health and life of women and children.One sixth HIV-related death and disease and one seventh the new HIV-infected people are under the age of 15 children,and ninety percent of the age of below 15 HIV-infected children are infected through mother-to-child transmission.Some studies in foreign countries have suggested that, mortality rate among children born to HIV infected mothers reach more than 20% at 2 years,and HIV/AIDS has become a main reason resμLting in the world child deaths.In many developing countries,HIV/AIDS epidemic has been offset all the progress in reducing infant and child mortality for many years.Because work in prevention of mother to child transmission of HIV is started in recent yeas,relative few related scientific research is carried out.There is no epidemiological data about the death of children born to HIV infected mothers in our country,lacking of the systemic study in the death of children born to HIV infected mothers and factors affected.Therefore,it is necessary for starting these studies.[OBJECTIVES]By investigating the death situation and effect factors of children born to HIV-infected mothers,it is to take specific intervention measures to reduce mortality rate of children born to HIV infected mothers,s based on the reference.[METHODS]We have established the study cohort of HIV-infected pregnant women and children in the Tenth Five-Year Study of the key issues in the region.In the basis of the study,we investigate the death situation of children who were born to HIV infected mothers in August 2008 to November 2008.Survey questionnaire is a verbal autopsy questionnaire,investigating the death of children to the child's parents or or other caregivers and,finding and reading health care in-patient medical records,death registration cards for children,children PMTCT follow-up questionnaire and laboratory testing resμLts.The purpose of investigating is to verify the death cause of children born to HIV infected mothers.At the same time, using data that have been collected in study cohort,it is to analyze effect factors by pearson chi-square test,Fisher exact probability mμLtivariate logistic regression model.Statistical software apply SPSS 15.0.[RESULTS]1.Neonate mortality among neonates born to HIV infected mothers is 33.71‰, infant mortality density for 110.78 per 1000 infant-year,mortality density of child under five years for 59.83 per 1000 child-year,differences between boys and girls in the neonatal mortality and infant mortality density were not statistical P＞0.05). Guangxi is the highest in Neonate mortality,infant mortality density and mortality density of child under five years among child born to HIV infected mothers, respectively reaching 41.32‰,164.87per 1000 infant-year and per 1000 child-year.2.Mortality rate in HIV-infected infants is 352.94‰,mortality rate is 62.5‰for uninfected infants born to HIV infected mothers;the ratio between the two is 5.65, and the ratio between uninfected infants mortality rate and the national infant mortality rate is 4.08.death children born to HIV infected mothers die before one year with 91.84%,death HIV-infected children also die before one year with81.82%. median survival time of HIV-infected children is 12.67 months(95%CI:0,27.16).3.The death of children born to HIV infected mothers is Aids death with 44.90%,cause-specific death density for 26.86 per 1000 child-years,premature low birth weight at the cause of death constitute second largest(14.29 percent),with cause-specific death density for 8.55 per 1000 child-years.33.33%neonatal deaths were born at home,the proportion is higher than the national ratio of home delivery among neonatal deaths(P＜0.05).The death children born to HIV infected mothers die at home with 81.63%,non-medical treatment for 40.82%,both ratio are higher than the national monitoring data(P＜0.05).4.The death risk of Neonate and infant who were born to HIV infected mothers in the early phase of AIDS or AIDS phase,is higher than Neonate and infant born to HIV infected mothers in AIDS incubation period.As the CD4+T lymphocyte count increased,the mortality is decreasing among Neonate and infant who were born to HIV infected mothers.PMTCT taking drugs,delivery selection, premature,the HIV status of infants and the reproductive history all affected the death of Neonate and infant who were born to HIV infected mothers,Feeding patterns does not affect the death of infant who were born to HIV infected mothers(P＞0.05). [CONCLUSIONS]1.Mortality density for children born to HIV infected mothers in our country, comparing with foreign-related research resμLts,is still at a higher level;Mortality density for children born to HIV infected mothers is the highest in Guangxi.2.Mortality ratio for HIV-infected children is high,most of the death of HIV-infected children occur in one year old,therefore it is necessary to carry out early diagnosis,so that HIV-infected infants receive timely antiviral treatment,to extend the lives of HIV-infected infants.3.Main factors impacting the death of infants born to HIV infected mothers include:the health of pregnant women,maternal CD4+lymphocyte count,taking PMTCT drugs,Delivery selection,premature,the HIV status of infants as well as the Reproductive history,and so on.In the prevention of mother to child transmission of HIV/AIDS work,it shoμLd take intervention measures according to effect factors,so that with the decreasing in the rate of mother to child transmission of HIV,Mortality for children born to HIV infected mothers is reduced at the same time.