BACKGROUND: Conflicting results have been reported among studies of protease inhibitor (PI) use during pregnancy and preterm birth. Uncontrolled confounding by indication may explain some of the differences among studies. METHODS: In total, 777 human immunodeficiency virus (HIV)-infected pregnant women in a prospective cohort who were not receiving antiretroviral (ARV) treatment at conception were studied. Births <37 weeks gestation were reviewed, and deliveries due to spontaneous labor and/or rupture of membranes were identified. Risk of preterm birth and low birth weight (<2500 g) were evaluated by using multivariable logistic regression. RESULTS: Of the study population, 558 (72%) received combination ARV with PI during pregnancy, and a total of 130 preterm births were observed. In adjusted analyses, combination ARV with PI was not significantly associated with spontaneous preterm birth, compared to ARV without PI (odds ratio [OR], 1.22; 95% confidence interval [CI], 0.70-2.12). Sensitivity analyses that included women who received ARV prior to pregnancy also did not identify a significant association (OR, 1.34; 95% CI, 0.84-2.16). Low birth weight results were similar. CONCLUSIONS: No evidence of an association between use of combination ARV with PI during pregnancy and preterm birth was found. Our study supports current guidelines that promote consideration of combination ARV for all HIV-infected pregnant women.
BACKGROUND: Conflicting results have been reported among studies of protease inhibitor (PI) use during pregnancy and preterm birth. Uncontrolled confounding by indication may explain some of the differences among studies. METHODS: In total, 777 human immunodeficiency virus (HIV)-infected pregnant women in a prospective cohort who were not receiving antiretroviral (ARV) treatment at conception were studied. Births <37 weeks gestation were reviewed, and deliveries due to spontaneous labor and/or rupture of membranes were identified. Risk of preterm birth and low birth weight (<2500 g) were evaluated by using multivariable logistic regression. RESULTS: Of the study population, 558 (72%) received combination ARV with PI during pregnancy, and a total of 130 preterm births were observed. In adjusted analyses, combination ARV with PI was not significantly associated with spontaneous preterm birth, compared to ARV without PI (odds ratio [OR], 1.22; 95% confidence interval [CI], 0.70-2.12). Sensitivity analyses that included women who received ARV prior to pregnancy also did not identify a significant association (OR, 1.34; 95% CI, 0.84-2.16). Low birth weight results were similar. CONCLUSIONS: No evidence of an association between use of combination ARV with PI during pregnancy and preterm birth was found. Our study supports current guidelines that promote consideration of combination ARV for all HIV-infected pregnant women.
Authors: M Ravizza; P Martinelli; A Bucceri; S Fiore; S Alberico; E Tamburrini; C Tibaldi; G Guaraldi; G Anzidei; A Maccabruni; M P Crisalli; M Floridia Journal: J Infect Dis Date: 2007-03-15 Impact factor: 5.226
Authors: I Grosch-Woerner; K Puch; R F Maier; T Niehues; G Notheis; D Patel; S Casteleyn; C Feiterna-Sperling; S Groeger; D Zaknun Journal: HIV Med Date: 2008-01 Impact factor: 3.180
Authors: Ruth E Tuomala; David E Shapiro; Lynne M Mofenson; Yvonne Bryson; Mary Culnane; Michael D Hughes; M J O'Sullivan; Gwendolyn Scott; Alice M Stek; Diane Wara; Marc Bulterys Journal: N Engl J Med Date: 2002-06-13 Impact factor: 91.245
Authors: Raymond Griner; Paige L Williams; Jennifer S Read; George R Seage; Marilyn Crain; Ram Yogev; Rohan Hazra; Kenneth Rich Journal: AIDS Patient Care STDS Date: 2011-06-10 Impact factor: 5.078
Authors: Kelesitse Phiri; Paige L Williams; Kate B Dugan; Michael A Fischer; William O Cooper; George R Seage; Sonia Hernandez-Diaz Journal: Pediatr Infect Dis J Date: 2015-07 Impact factor: 2.129
Authors: Helena Lucia Barroso Dos Reis; Karina da Silva Araujo; Lilian Paula Ribeiro; Daniel Ribeiro Da Rocha; Drielli Petri Rosato; Mauro Romero Leal Passos; Paulo Roberto Merçon De Vargas Journal: Rev Inst Med Trop Sao Paulo Date: 2015 Mar-Apr Impact factor: 1.846
Authors: Kathleen M Powis; Douglas Kitch; Anthony Ogwu; Michael D Hughes; Shahin Lockman; Jean Leidner; Erik van Widenfelt; Claire Moffat; Sikhulile Moyo; Joseph Makhema; Max Essex; Roger L Shapiro Journal: J Infect Dis Date: 2011-08-15 Impact factor: 5.226
Authors: Risa M Hoffman; Erin Leister; Deborah Kacanek; David E Shapiro; Jennifer S Read; Yvonne Bryson; Judith S Currier Journal: J Acquir Immune Defic Syndr Date: 2013-08-15 Impact factor: 3.731
Authors: Nandita Sugandhi; Jessica Rodrigues; Maria Kim; Saeed Ahmed; Anouk Amzel; Mike Tolle; Eric J Dziuban; Scott E Kellerman; Emilia Rivadeneira Journal: AIDS Date: 2013-11 Impact factor: 4.177
Authors: D Heather Watts; Paige L Williams; Deborah Kacanek; Raymond Griner; Kenneth Rich; Rohan Hazra; Lynne M Mofenson; Hermann A Mendez Journal: J Infect Dis Date: 2012-11-29 Impact factor: 5.226