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. 2010 Feb;53(2):176-85.
doi: 10.1097/QAI.0b013e3181c5c81f.

Maternal antiretroviral use during pregnancy and infant congenital anomalies: the NISDI perinatal study

Esau C Joao  1 , Guilherme A Calvet, Margot R Krauss, Laura Freimanis Hance, Javier Ortiz, Silvina A Ivalo, Russell Pierre, Mary Reyes, D Heather Watts, Jennifer S Read; NISDI Perinatal Study Group
Collaborators, Affiliations

Maternal antiretroviral use during pregnancy and infant congenital anomalies: the NISDI perinatal study

Esau C Joao et al. J Acquir Immune Defic Syndr. 2010 Feb.

Abstract

Background: We evaluated the association between maternal antiretrovirals (ARVs) during pregnancy and infant congenital anomalies (CAs), utilizing data from the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study.

Methods: The study population consisted of first singleton pregnancies on study, > or =20 weeks gestation, among women enrolled in NISDI from Argentina and Brazil who delivered between September 2002 and October 2007. CAs were defined as any major structural or chromosomal abnormality, or a cluster of 2 or more minor abnormalities, according to the conventions of the Antiretroviral Pregnancy Registry. CAs were identified from fetal ultrasound, study visit, and death reports. Prevalence rates [number of CAs per 100 live births (LBs)] were calculated for specific ARVs, classes of ARVs, and overall exposure to ARVs.

Results: Of 1229 women enrolled, 995 pregnancy outcomes (974 LBs) met the inclusion criteria. Of these, 60 infants (59 LBs and 1 stillbirth) had at least 1 CA. The overall prevalence of CAs (per 100 LBs) was 6.2 [95% confidence interval (CI) 4.6 to 7.7]. The prevalence of CAs after first trimester ARVs (6.2; 95% CI 3.1 to 9.3) was similar to that after second (6.8; 95% CI 4.5 to 9.0) or third trimester (4.3; 95% CI 1.5 to 7.2) exposure. The rate of CAs identified within 7 days of delivery was 2.36 (95% CI 1.4 to 3.3).

Conclusions: The prevalence of CAs after first trimester exposure to ARVs was similar to that after second or third trimester exposure. Continued surveillance for CAs among children exposed to ARVs during gestation is needed.

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Conflict of interest statement

Conflict of interest: There are no conflicts of interest to disclose.

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