06/13/2002 By Elda Hauschildt
Use of combined antiretroviral therapy by women with human immunodeficiency virus type 1 (HIV-1) is not associated with increased risk of premature delivery – less than 37 weeks gestation – or other late-pregnancy adverse outcomes.
United States researchers found that use of combination antiretroviral treatment for HIV-1 infection in pregnant women is not associated with low birthweight, low Apgar scores or stillbirth compared with no antiretroviral therapy or monotherapy.
They suggest an association with protease inhibitors and increased risk of very low birthweight needs to be confirmed.
“Our data provide reassurance that the risks of adverse outcomes of pregnancy that are attributable to antiretroviral therapy are low and are likely to be outweighed by the recognised benefits of such therapy during pregnancy,” say investigators, led by Dr. Ruth E. Tuomala of Brigham and Women’s Hospital in Boston, Massachusetts.
A cohort of 2,123 women with HIV-1 infection who received antiretroviral therapy during pregnancy was enrolled in one of seven clinical studies.
Participants delivered their babies from 1990 to 1998. A total of 1,590 women received monotherapy, 396 had combination therapy without protease inhibitors and 137 took combination therapy with protease inhibitors. Another 1,143 women did not receive antiretroviral therapy. Rate of premature delivery was similar among women who received antiretroviral therapy (16 percent) and those who did not (17 percent). Rate of low birthweight among infants born to both groups was 16 percent.
Very low birthweight (less than 1,500 grams) was at 2 percent in women receiving antiretroviral therapy and 1 percent in women who did not.
The researchers say the rates of low Apgar score and stillbirth was similar in the two groups.
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