Birth defects among a cohort of infants born to HIV-infected women on antiretroviral medication

D. Heather Watts, Sharon Huang, Mary Culnane, Kathleen A. Kaiser, Angela Scheuerle, Lynne Mofenson, Kenneth Stanley, Marie Louise Newell, Laurent Mandelbrot, Jean Francois Delfraissy, Coleen K. Cunningham

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Objective: To determine rate of and risk factors for birth defects in infants born to HIV-infected women receiving nucleoside and protease inhibitor antiretroviral (ARV) therapy. Methods: Birth defects were evaluated among infants on the Pediatric AIDS Clinical Trials Group 316 trial that studied addition of peripartum nevirapine to established ARV regimen for prevention of mother-to-child transmission. Maternal therapy was categorized by trimester of earliest exposure. Birth defects were coded using conventions of the Antiretroviral Pregnancy Registry. Results: Birth defects were detected in 60/1414 (4.2%; 95% CI 3.3-5.4%) infants including 30/636 (4.7%; 95% CI 3.2-6.7%) with first trimester ARV exposure and 30/778 (3.9%; 95% CI 2.6-5.5%) with exposure only after the first trimester (P=0.51). Rates of classes of defects were similar between first trimester compared to later exposure groups except heart defects which occurred in 16 (2.5%; 95% CI 1.4-4.1%) with first trimester ARV exposure and in six (0.8%; 95% CI 0.3-1.7%) infants with later exposure (P=0.02). Exposure to ARV was not associated with specific types of heart defects. Two cases of cardiomyopathy were noted. Conclusion: ARV use in early pregnancy was not associated with an increased risk of birth defects overall. The possible association of ARV exposure with heart defects requires further surveillance.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalJournal of Perinatal Medicine
Volume39
Issue number2
DOIs
StatePublished - Mar 1 2011

Keywords

  • Antiretrovirals
  • HIV
  • birth defects

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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    Watts, D. H., Huang, S., Culnane, M., Kaiser, K. A., Scheuerle, A., Mofenson, L., Stanley, K., Newell, M. L., Mandelbrot, L., Delfraissy, J. F., & Cunningham, C. K. (2011). Birth defects among a cohort of infants born to HIV-infected women on antiretroviral medication. Journal of Perinatal Medicine, 39(2), 163-170. https://doi.org/10.1515/JPM.2010.139