Timing of Antiretroviral Therapy: Initiation and Birth Outcomes Among Pregnant Women With Human Immunodeficiency Virus in Tanzania
J Infect Dis
; 226(4): 687-695, 2022 09 04.
Article
em En
| MEDLINE
| ID: mdl-35678698
ABSTRACT
BACKGROUND:
Combination antiretroviral therapy (cART) initiation during pregnancy reduces the risk of perinatal human immunodeficiency virus (HIV) transmission; however, studies have suggested that there may be unintended adverse consequences on birth outcomes for selected cART regimens.METHODS:
We analyzed adverse birth outcomes among a prospective cohort of 1307 pregnant women with HIV in Dar es Salaam who initiated cART during the first or second trimester of a singleton pregnancy. Our primary analysis compared birth outcomes by gestational age at cART initiation among these women initiating cART in pregnancy.RESULTS:
Among women who initiated cART in pregnancy, there was no relationship of gestational age at cART initiation with the risk of fetal death or stillbirth. However, women who initiated cART before 20 weeks of gestation compared with after 20 weeks had increased risk of preterm birth (risk ratio [RR], 1.30; 95% confidence interval [CI], 1.03-1.67) but decreased risk of small-for-gestational age birth (RR, 0.71; 95% CI, .55-.93).CONCLUSIONS:
With increasing use of cART preconception and early in pregnancy, clinicians should be aware of the benefits and potential risks of cART regimens to optimize birth outcomes.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
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Infecções por HIV
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Nascimento Prematuro
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article