HIV/AIDS Obstetrics: Protease inhibitor-containing HAART associated with increased risk of preterm delivery

AIDSWEEKLY Plus; Monday, July 3, 2006
Staff Medical Writers

"Data on complications of pregnancy associated with antiretroviral therapy are limited. Some small studies have demonstrated an increased preterm delivery rate, but a recent retrospective United States multisite study did not concur with these findings," scientists in the United States report.

According to A.M. Cotter and colleagues at the University of Miami, "Our objective was to investigate whether antiretroviral therapy was associated with adverse pregnancy outcome at a single site.

"Using prospectively gathered data, women were identified who were determined to be human immunodeficiency virus positive before or during pregnancy who sought care at our prenatal clinic and who gave birth at the University of Miami/Jackson Memorial Medical Center from 1990 through 2002."

"The outcome measures were preterm delivery, low birth weight, and stillbirth. The cohort included 999 women who received antiretroviral therapy during pregnancy (monotherapy in 492, combination therapy without a protease inhibitor [PI] in 373, and combination therapy with a PI in 134) and 338 women who did not receive therapy," researchers said.

"After adjustment for possible confounders," wrote the authors, "only combination therapy with a PI was associated with an increased risk of preterm delivery, compared with any other combination (odds ratio, 1.8 [95% confidence interval, 1.1-3.0])."

Cotter concluded, "There were no differences in rates of low birth weight and stillbirth, regardless of therapy. Compared with monotherapy and combination therapy without a PI, only combination therapy with a PI was associated with an increased risk of preterm delivery."

Cotter and colleagues published their study in the Journal of Infectious Diseases (Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth? J Infect Dis. 2006 May 1;193(9):1195-201).

For more information, contact A.M. Cotter, University of Miami, Dept. Obstetrics & Gynecology, Division Maternal Fetal Med, POB 016960, R-136, Miami, FL 33101, USA.

Publisher contact information for the Journal of Infectious Diseases is: University Chicago Press, 1427 E 60th St., Chicago, IL 60637-2954, USA.

Keywords: Miami, Florida, United States, HIV/AIDS, HAART, Protease Inhibitor, Preterm Delivery.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Cotter AM, Garcia AG, Duthely ML, et al., “Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth?”, J Infect Dis. 2006 May 1;193(9):1195-201.

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