Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001–2011. Issue 12 (31st May 2013)

• Record Type: Journal Article
• Authors: Floridia, M; Mastroiacovo, P; Tamburrini, E; Tibaldi, C; Todros, T; Crepaldi, A; Sansone, M; Fiscon, M; Liuzzi, G; Guerra, B; Vimercati, A; Vichi, F; Vicini, I; Pinnetti, C; Marconi, AM; Ravizza, M
• Is Part Of: BJOG. Volume 120:Issue 12(2013:Dec.)
• Page Start: 1466
• Page End: 1476
• Publication Date: 2013-05-31
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12285
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12285-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12285-sec-0001" sec-type="section"> <title>Objective</title> <p>We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection.</p> </sec> <sec id="bjo12285-sec-0002" sec-type="section"> <title>Design</title> <p>Observational study.</p> </sec> <sec id="bjo12285-sec-0003" sec-type="section"> <title>Setting</title> <p>University and hospital clinics.</p> </sec> <sec id="bjo12285-sec-0004" sec-type="section"> <title>Population</title> <p>Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy.</p> </sec> <sec id="bjo12285-sec-0005" sec-type="section"> <title>Methods</title> <p>The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses.</p> </sec> <sec id="bjo12285-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria.</p> </sec> <sec id="bjo12285-sec-0007" sec-type="section"> <title>Results</title> <p>A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty‐two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first‐trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non‐nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%).</p> </sec> <sec id="bjo12285-sec-0008" sec-type="section"> <title>Conclusions</title> <p>This study adds further support to the assumption that first‐trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.</p> </sec> </abstract>