Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth?

Amanda M. Cotter, Adolfo Gonzalez Garcia, M. Lunthita Duthely, Barbara Luke, Mary J. O'Sullivan

Research output: Contribution to journalArticle

173 Citations (Scopus)

Abstract

Background. Data on complications of pregnancy associated with antiretroviral therapy are limited. Some small studies have demonstrated an increased preterm delivery rate, but a recent retrospective United States multisite study did not concur with these findings. Our objective was to investigate whether antiretroviral therapy was associated with adverse pregnancy outcome at a single site. Methods. Using prospectively gathered data, women were identified who were determined to be human immunodeficiency virus positive before or during pregnancy who sought care at our prenatal clinic and who gave birth at the University of Miami/Jackson Memorial Medical Center from 1990 through 2002. The outcome measures were preterm delivery, low birth weight, and stillbirth. Results. The cohort included 999 women who received antiretroviral therapy during pregnancy (monotherapy in 492, combination therapy without a protease inhibitor [PI] in 373, and combination therapy with a PI in 134) and 338 women who did not receive therapy. After adjustment for possible confounders, only combination therapy with a PI was associated with an increased risk of preterm delivery, compared with any other combination (odds ratio, 1.8 [95% confidence interval, 1.1-3.0]). There were no differences in rates of low birth weight and stillbirth, regardless of therapy. Conclusion. Compared with monotherapy and combination therapy without a PI, only combination therapy with a PI was associated with an increased risk of preterm delivery.

Original languageEnglish
Pages (from-to)1195-1201
Number of pages7
JournalJournal of Infectious Diseases
Volume193
Issue number9
DOIs
StatePublished - May 1 2006

Fingerprint

Stillbirth
Low Birth Weight Infant
Pregnancy
Protease Inhibitors
Therapeutics
Pregnancy Complications
Pregnancy Outcome
Odds Ratio
Outcome Assessment (Health Care)
HIV
Parturition
Confidence Intervals

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth? / Cotter, Amanda M.; Garcia, Adolfo Gonzalez; Duthely, M. Lunthita; Luke, Barbara; O'Sullivan, Mary J.

In: Journal of Infectious Diseases, Vol. 193, No. 9, 01.05.2006, p. 1195-1201.

Research output: Contribution to journalArticle

Cotter, Amanda M. ; Garcia, Adolfo Gonzalez ; Duthely, M. Lunthita ; Luke, Barbara ; O'Sullivan, Mary J. / Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth?. In: Journal of Infectious Diseases. 2006 ; Vol. 193, No. 9. pp. 1195-1201.
@article{c3ddf4da5dc8466db5a128845b1e900b,
title = "Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth?",
abstract = "Background. Data on complications of pregnancy associated with antiretroviral therapy are limited. Some small studies have demonstrated an increased preterm delivery rate, but a recent retrospective United States multisite study did not concur with these findings. Our objective was to investigate whether antiretroviral therapy was associated with adverse pregnancy outcome at a single site. Methods. Using prospectively gathered data, women were identified who were determined to be human immunodeficiency virus positive before or during pregnancy who sought care at our prenatal clinic and who gave birth at the University of Miami/Jackson Memorial Medical Center from 1990 through 2002. The outcome measures were preterm delivery, low birth weight, and stillbirth. Results. The cohort included 999 women who received antiretroviral therapy during pregnancy (monotherapy in 492, combination therapy without a protease inhibitor [PI] in 373, and combination therapy with a PI in 134) and 338 women who did not receive therapy. After adjustment for possible confounders, only combination therapy with a PI was associated with an increased risk of preterm delivery, compared with any other combination (odds ratio, 1.8 [95{\%} confidence interval, 1.1-3.0]). There were no differences in rates of low birth weight and stillbirth, regardless of therapy. Conclusion. Compared with monotherapy and combination therapy without a PI, only combination therapy with a PI was associated with an increased risk of preterm delivery.",
author = "Cotter, {Amanda M.} and Garcia, {Adolfo Gonzalez} and Duthely, {M. Lunthita} and Barbara Luke and O'Sullivan, {Mary J.}",
year = "2006",
month = "5",
day = "1",
doi = "10.1086/503045",
language = "English",
volume = "193",
pages = "1195--1201",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Is antiretroviral therapy during pregnancy associated with an increased risk of preterm delivery, low birth weight, or stillbirth?

AU - Cotter, Amanda M.

AU - Garcia, Adolfo Gonzalez

AU - Duthely, M. Lunthita

AU - Luke, Barbara

AU - O'Sullivan, Mary J.

PY - 2006/5/1

Y1 - 2006/5/1

N2 - Background. Data on complications of pregnancy associated with antiretroviral therapy are limited. Some small studies have demonstrated an increased preterm delivery rate, but a recent retrospective United States multisite study did not concur with these findings. Our objective was to investigate whether antiretroviral therapy was associated with adverse pregnancy outcome at a single site. Methods. Using prospectively gathered data, women were identified who were determined to be human immunodeficiency virus positive before or during pregnancy who sought care at our prenatal clinic and who gave birth at the University of Miami/Jackson Memorial Medical Center from 1990 through 2002. The outcome measures were preterm delivery, low birth weight, and stillbirth. Results. The cohort included 999 women who received antiretroviral therapy during pregnancy (monotherapy in 492, combination therapy without a protease inhibitor [PI] in 373, and combination therapy with a PI in 134) and 338 women who did not receive therapy. After adjustment for possible confounders, only combination therapy with a PI was associated with an increased risk of preterm delivery, compared with any other combination (odds ratio, 1.8 [95% confidence interval, 1.1-3.0]). There were no differences in rates of low birth weight and stillbirth, regardless of therapy. Conclusion. Compared with monotherapy and combination therapy without a PI, only combination therapy with a PI was associated with an increased risk of preterm delivery.

AB - Background. Data on complications of pregnancy associated with antiretroviral therapy are limited. Some small studies have demonstrated an increased preterm delivery rate, but a recent retrospective United States multisite study did not concur with these findings. Our objective was to investigate whether antiretroviral therapy was associated with adverse pregnancy outcome at a single site. Methods. Using prospectively gathered data, women were identified who were determined to be human immunodeficiency virus positive before or during pregnancy who sought care at our prenatal clinic and who gave birth at the University of Miami/Jackson Memorial Medical Center from 1990 through 2002. The outcome measures were preterm delivery, low birth weight, and stillbirth. Results. The cohort included 999 women who received antiretroviral therapy during pregnancy (monotherapy in 492, combination therapy without a protease inhibitor [PI] in 373, and combination therapy with a PI in 134) and 338 women who did not receive therapy. After adjustment for possible confounders, only combination therapy with a PI was associated with an increased risk of preterm delivery, compared with any other combination (odds ratio, 1.8 [95% confidence interval, 1.1-3.0]). There were no differences in rates of low birth weight and stillbirth, regardless of therapy. Conclusion. Compared with monotherapy and combination therapy without a PI, only combination therapy with a PI was associated with an increased risk of preterm delivery.

UR - http://www.scopus.com/inward/record.url?scp=33646038009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646038009&partnerID=8YFLogxK

U2 - 10.1086/503045

DO - 10.1086/503045

M3 - Article

C2 - 16586354

AN - SCOPUS:33646038009

VL - 193

SP - 1195

EP - 1201

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 9

ER -