Objective: We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design: Observational study. Setting: University and hospital clinics. Population: Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods: The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures: Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results: A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9-4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9-4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51-1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51-1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56-2.55; protease inhibitors, OR 0.92, 95% CI 0.43-1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions: This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.

Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011 / M. Floridia, P. Mastroiacovo, E. Tamburrini, C. Tibaldi, T. Todros, A. Crepaldi, M. Sansone, M. Fiscon, G. Liuzzi, B. Guerra, A. Vimercati, F. Vichi, I. Vicini, C. Pinnetti, A. Marconi, M. Ravizza, F. Mori, P. Ortolani, E. Dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, M. Zaramella, B. Mariani, G. Natalini Raponi, G. Guaraldi, K. Luzi, G. Nardini, C. Stentarelli, A. Degli Antoni, A. Molinari, M. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Giacomet, V. Fabiano, S. Coletto, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, D. Francisci, L. Bernini, S. Alberico, G. Maso, M. Tropea, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, A. Spinillo, M. Roccio, A. Miccolis, E. Bassi, B. Guerra, F. Cervi, C. Puccetti, P. Murano, M. Contoli, M. Capretti, C. Marsico, G. Faldella, P. Martinelli, A. Agangi, C. Tibaldi, L. Trentini, G. Masuelli, S. Garetto, I. Cetin, T. Brambilla, V. Savasi, A. Crepaldi, C. Giaquinto, M. Fiscon, R. Rinaldi, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, C. Fundarò, O. Genovese, C. Cafforio, V. Tozzi, P. Massetti, M. Anceschi, A. Casadei, A. Cavaliere, V. Finelli, M. Cellini, G. Castelli Gattinara, A. Marconi, S. Dalzero, V. Sacchi, A. De Pirro, C. Polizzi, A. Mattei, M. Pirillo, R. Amici, C. Galluzzo, S. Donnini, S. Baroncelli, M. Regazzi, P. Villani, M. Cusato, A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, S. Vella, P. Martinelli. - In: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. - ISSN 1470-0328. - 120:12(2013 May), pp. 1466-1476. [10.1111/1471-0528.12285]

Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011

A. Crepaldi;A. Marconi;M. Meli
Membro del Collaboration Group
;
V. Mercurio
Membro del Collaboration Group
;
A. Molinari
Membro del Collaboration Group
;
G. Zuccotti
Membro del Collaboration Group
;
V. Giacomet
Membro del Collaboration Group
;
V. Fabiano
Membro del Collaboration Group
;
A. Meloni
Membro del Collaboration Group
;
S. Garetto
Membro del Collaboration Group
;
I. Cetin;V. Savasi
Membro del Collaboration Group
;
A. Marconi
Membro del Collaboration Group
;
S. Dalzero
Membro del Collaboration Group
;
A. Mattei
Membro del Collaboration Group
;
M. Moroni
Membro del Collaboration Group
;
F. Parazzini
Membro del Collaboration Group
;
2013

Abstract

Objective: We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design: Observational study. Setting: University and hospital clinics. Population: Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods: The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures: Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results: A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9-4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9-4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51-1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51-1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56-2.55; protease inhibitors, OR 0.92, 95% CI 0.43-1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions: This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.
Antiretroviral therapy; HIV; birth defects; efavirenz; non-nucleoside reverse transcriptase inhibitors; nucleoside reverse transcriptase inhibitors; pregnancy; protease inhibitors; women; Abnormalities, Drug-Induced; Adolescent; Adult; Anti-HIV Agents; Birth Weight; Cohort Studies; Coinfection; Female; HIV Infections; Hepatitis B, Chronic; Hepatitis C, Chronic; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Italy; Male; Maternal Exposure; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Prevalence; Reverse Transcriptase Inhibitors; Young Adult; Obstetrics and Gynecology
Settore MED/38 - Pediatria Generale e Specialistica
Settore MED/40 - Ginecologia e Ostetricia
mag-2013
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/227275
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