Pregnancy outcome among HIV-infected women on different antiretroviral therapies in Ethiopia: a cohort study.
HIV
antiretroviral therapy
low birth weight
preterm birth
small-for-gestational-age
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
05 08 2019
05 08 2019
Historique:
entrez:
7
8
2019
pubmed:
7
8
2019
medline:
28
8
2020
Statut:
epublish
Résumé
The objective of the study was to compare pregnancy outcomes according to maternal antiretroviral treatment (ART) regimens. A retrospective cohort study. Clinical data was extracted from ART exposed pregnancies of HIV-infected Ethiopian women attending antenatal care follow-up in public health facilities in Addis Ababa between February 2010 and October 2016. The primary outcomes evaluated were preterm birth, low birth weight and small-for-gestational-age. A total 1663 of pregnancies exposed to ART were included in the analyses. Of these pregnancies, 17% resulted in a preterm birth, 19% in low birth weight and 32% in a small-for-gestational-age baby. Compared with highly active antiretroviral therapy (HAART) initiated during pregnancy, zidovudine monotherapy was less likely to result in preterm birth (adjusted OR 0.35, 95% CI 0.19 to 0.64) and low birth weight (adjusted OR 0.48, 95% CI 0.24 to 0.94). We observed no differential risk of preterm birth, low birth weight and small-for-gestational-age, when comparing women who initiated HAART during pregnancy to women who initiated HAART before conception. The risk for preterm birth was higher in pregnancies exposed to nevirapine-based HAART (adjusted OR 1.44, 95% CI 1.06 to 1.96) compared with pregnancies exposed to efavirenz-based HAART. Comparing nevirapine-based HAART with efavirenz-based HAART indicated no strong evidence of increased risk of low birth weight or small-for-gestational-age. We observed a higher risk of preterm birth among women who initiated HAART during pregnancy compared with zidovudine monotherapy. Pregnancies exposed to nevirapine-based HAART also had a greater risk of preterm births compared with efavirenz-based HAART.
Identifiants
pubmed: 31383698
pii: bmjopen-2018-027344
doi: 10.1136/bmjopen-2018-027344
pmc: PMC6687026
doi:
Substances chimiques
Anti-Retroviral Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e027344Subventions
Organisme : Medical Research Council
ID : MC_UU_12013/5
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M009351/1
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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