Fatores de risco associados à gestantes com HIV positivo

Abstract

HIV infection represents a serious problem for the Public Health system. Epidemiological indicators show that HIV/aids has infected more and more women, as they present biological and social factors that make them more susceptible to the risk of contamination. With the arrival of antiretrovirals and the early diagnosis of the virus in pregnant women it is possible to reduce the risk of vertical transmission. Objective: analyze the risk factors associated with pregnant women that are HIV positive attended to by the specialized service of a hospital school. Method: Epidemiological, observational, retrospective, and quantitative approach cohort study, whose data comes from secondary sources of pregnant women with HIV between 2014 and 2018 and attended to at the Lauro Wanderley of Paraíba University Hospital. The data was collected from secondary sources using the medical records of pregnant women that were attended to at the University Hospital. Resultingly, an accessible population of 382 consultations was obtained, and based on this population a sample calculation with a confidence level of 95% and error of 0.05 was carried out yielding a sample of 193 medical records. Data collection was carried out between November 2019 and February 2020. The data was analyzed using Descriptive Statistics, the Chi-Square Test, the Binary Logistic Regression Model, WOE and the Decision Tree. Results: In the Chi-Square test it was possible to identify the association of independent variables with the viral load. The Binary Logistic Regression Model presented only two significant variables, thus making the construction of a final model unviable. The model identified as risk factors for this outcome the carrying out of nutritional monitoring and the use of Antiretroviral Therapy (ART). With the WOE model generated it was possible to observe that the variable of pregnancy age at the first consultation presented the greatest evidence that could explain the occurrence of the outcome. The decision tree was capable of presenting the risk factors that could explain the study outcome, or in other words, variables were selected that were capable of predicting if a pregnant woman could have a detectable or undetectable viral load. The model was capable of correctly classifying 81.3% and obtained a Kappa of 62%. As a result of this, the study brought important information to the forefront that demonstrates which factors can interfere in maternal health and that of the baby. Conclusion: knowing the risk factors can help health professionals to improve the care given to pregnant women promoting less complications and specific monitoring.