Pregnancy, delivery mode, and infant feeding among HIV-infected women in China: A meta-analysis

Objective To know about the ongoing pregnancy rate,cesarean section rate of HIV-infected pregnant women and formula feeding rate of their infants in China during 2003-2011.Methods Databases including PubMed,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical Database(VIP),Wanfang Database(WF)and Chinese Biological Medical Literature Database(CBM)were searched from the date of their establishment to May 2013;the literatures published in both Chinese and English reporting ongoing pregnancy,cesarean section of HIV-infected pregnant women,or formula feeding of their infants were collected.Then according to the inclusion criteria,two researchers independently screened the literature,extracted the data and assessed the quality of the included articles.Meta-analyses were conducted using the Comprehensive Meta-Analysis software(V2.0,Biostat,Englewood,New Jersey).Meta regression analysis was conducted to identify the source of heterogeneity.Results Of the total 2 356 records,61eligible articles were finally included.The results of meta-analysis showed that nationally,the rate of pregnancy continuation rates among HIV-infected pregnant women during 2003-2011 were 67.50%(95%CI[51.73%,80.10%]),60.49%(95%CI[18.59%,91.13%]),51.80%(95%CI[28.13%,74.68%]),62.59%(95%CI[54.60%,69.96%]),64.93%(95%CI[50.18%,77.29%]),70.65%(95%CI[62.20%,77.88%]),65.66%(95%CI[59.70%,71.16%]),67.85%(95%CI[52.66%,80.02%]),and 75.00%(95%CI[59.46%,85.99%]),respectively;the caesarean section rates among these women during 2004-2010 were 26.33%(95%CI[9.41%,55.14%]),43.40%(95%CI[34.30%,52.96%]),42.57%(95%CI[35.73%,49.70%]),69.43%(95%CI[13.48%,97.07%]),46.68%(95%CI[27.27%,67.16%]),61.14%(95%CI[49.37%,71.75%])and 56.60%(95%CI[36.36%,74.85%]),respectively;and the formula feeding rates of exposed infants were kept at relatively high levels(90.00% above)for all the years except for 2005,which was 82.65%.Conclusion The overall rate of pregnancy continuation of HIV-infected pregnant women represents an increase in recent years in China;the cesarean section rate is high,fluctuating and increasing;the formula feeding rate of their infants keeps stable at a high level.