围产期结局与怀孕期间预防艾滋病毒的暴露前预防相关:系统性审查和元分析
Alison Erlwanger1, Isabelle Rocroi1, Shona Kirtley2
1National Perinatal Epidemiology Unit, Infectious Disease Epidemiology Unit, Oxford Population Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
EClinicalMedicine
|April 30, 2024
概括
在怀孕期间使用暴露前预防 (PrEP) 时,没有增加不良周产期结果的风险. 这一系统性审查支持世卫组织对孕妇口服PrEP的建议,尽管需要更多关于所有方式的数据.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 生殖健康 生殖健康
背景情况:
- 怀孕增加了母亲的艾滋病毒风险和传播潜力.
- 世卫组织建议口服PrEP,达皮维林阴道环和CAB-LA用于预防艾滋病毒.
- 本综述检查了与产前PrEP暴露的围产期结局.
研究的目的:
- 评估暴露于任何PrEP模式的HIV阴性孕妇的周产期不良结果的风险.
- 综合来自随机对照试验和关于孕期PrEP安全性的队列研究的证据.
主要方法:
- 2000年1月至2023年8月发表的研究的系统审查和元分析.
- 包括13项研究 (8项RCT,5个队列),涉及非洲8712名孕妇.
- 评估了13个围产期结局,包括早产,低出生体重和新生儿死亡.
主要成果:
- 在RCT或未调整的队列研究中,口服PrEP与早产无关.
- 在调整后的队列研究中,口服PrEP与早产风险降低有关.
- 没有发现口服PrEP与低出生体重,SGA或新生儿死亡之间的关联. 达皮维林环没有显示任何不良关联. 没有关于CAB-LA的数据.
结论:
- 没有证据表明与怀孕期间的PrEP暴露相关的围产期不良结果.
- 这些发现支持世卫组织对孕妇口服PrEP的建议.
- 需要进一步研究所有PrEP模式在怀孕期间的安全性.
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