Association between preterm birth and Antiretroviral Exposur
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Infants HIV-exposed and uninfected (IHEU) who are born to women living with HIV are at an increased risk of preterm birth (PTB). Antenatal exposure to certain maternal antiretroviral therapy (ART) regimens has been associated with PTB, although existing studies in this domain are limited and report discordant findings. Researchers determined odds of PTB among IHEU by antenatal ART regimens and timing of exposure, adjusting for maternal risk factors.

IHEU born in British Columbia (BC), Canada between 1990 and 2012 utilizing provincial health administrative databases were retrospectively studied. Data from a control group of infants HIV-unexposed and uninfected (IHUU) matched ~3:1 for each IHEU on age, sex and geocode were included.

Results:
-- A total of 411 IHEU and 1224 IHUU were included in univariable analysis.
-- PTB was more frequent among IHEU (20%) compared with IHUU (7%).
--IHEU were more often antenatally exposed to alcohol, tobacco, as well as prescription, nonprescription, and illicit drugs (IHEU: 36%, 8% and 35%; vs. IHUU: 3%, 1% and 9%, respectively).
--After adjusting for maternal substance use and smoking exposure, IHEU remained at increased odds of PTB [adjusted odds ratio (aOR) (95% CI): 2.66] compared with matched IHUU controls.
--ART-exposed IHEU (excluding those with NRTIs only ART) had lower adjusted odds of PTB compared with IHEU with no maternal ART exposure, regardless of regimen [aOR range: 0.16–0.29].
--Odds of PTB between IHEU exposed to ART from conception compared with IHEU exposed to ART postconception did not differ [aOR: 0.91]; however, both groups experienced lower odds of PTB compared with IHEU with no maternal ART [preconception: aOR: 0.28; postconception: aOR 0.30].

Finally, compared to demographically matched controls, BC IHEU were over twice likely to be born prematurely. This risk has been modulated by maternal use in pregnancy; however, no PTB adverse links to antenatal ART exposure have been identified.

Source: https://journals.lww.com/pidj/Abstract/2021/03000/Preterm_Birth_and_Antiretroviral_Exposure_in.15.aspx
Like
Comment
Share