Pregnancy Outcomes of Women Conceiving on Antiretroviral Therapy (ART) Compared to Those Commenced on ART During Pregnancy
| Autor: | Mauricio Pinilla, Maxensia Owor, Nahida Chakhtoura, Renee Browning, Mary Glenn Fowler, Avy Violari, Katie McCarthy, Gerhard Theron, Lee Fairlie, Dhayendre Moodley, Bonus Makanani, Lameck Chinula, Risa M Hoffman, Sean S Brummel |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty pregnancy outcomes Breastfeeding HIV Infections Abortion 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Pregnancy Complications Infectious Online Only Articles business.industry Obstetrics Hazard ratio Infant Newborn Pregnancy Outcome HIV Stillbirth medicine.disease 030112 virology Infectious Disease Transmission Vertical Clinical trial Major Articles and Commentaries Low birth weight AcademicSubjects/MED00290 Breast Feeding Infectious Diseases Relative risk Female conceiving on ART medicine.symptom business Breast feeding |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 0106-1151 |
| DOI: | 10.1093/cid/ciaa805 |
| Popis: | Background Globally, the number of infected women of childbearing age living with human immunodeficiency virus (HIV) and conceiving on antiretroviral therapy (ART) is increasing. Evidence of ART safety at conception and during pregnancy and adverse pregnancy outcomes remains conflicting. The Promoting Maternal and Infant Survival Everywhere (PROMISE) 1077 breastfeeding (BF) and formula feeding (FF) international multisite trials provide an opportunity to examine the impact of ART at conception on pregnancy outcomes with subsequent pregnancies. Methods The PROMISE 1077BF/1077FF trials were designed to address key questions in the management of HIV-infected women who did not meet clinical guidelines for ART treatment during the time of the trials. After the period of risk of mother-to-child transmission was over, women were randomized to either continue or discontinue ART. We compared subsequent pregnancy outcomes of nonbreastfeeding women randomized to continue ART following delivery, or breastfeeding women randomized to continue ART following breastfeeding cessation who conceived while on ART to women randomized to discontinue ART, who restarted ART after pregnancy was diagnosed. Results Pregnancy outcomes of 939 subsequent pregnancies of 826 mothers were recorded. The intention-to-treat analyses showed increased incidence of low birth weight ( Globally more women living with HIV conceive on antiretroviral therapy (ART). This study reports an increased risk of low birth weight, spontaneous abortion, stillbirth, and neonatal death for women conceiving on ART compared to those not on ART at conception. |
| Databáze: | OpenAIRE |
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