Birth outcomes in South African women receiving antiretroviral therapy
Author Information
Author(s): van der Merwe Karin, Hoffman Risa, Black Vivian, Chersich Matthew, Coovadia Ashraf, Rees Helen
Primary Institution: University of the Witwatersrand
Hypothesis
Is in utero exposure to highly active antiretroviral therapy (HAART) associated with low birth weight and/or preterm birth in South African women with advanced HIV disease?
Conclusion
In this immunocompromised cohort, in utero HAART exposure was not associated with low birth weight, but an association between NNRTI-based HAART and preterm birth was detected.
Supporting Evidence
- 27% of HAART-unexposed infants were low birth weight compared to 23% of early HAART-exposed and 19% of late HAART-exposed infants.
- Every 50 cells/mm3 increase in CD4 count was associated with a 57% reduction in the odds of low birth weight.
- HAART exposure was associated with an increased preterm birth rate of 15%.
Takeaway
This study looked at pregnant women in South Africa taking HIV medicine and found that the medicine didn't cause babies to be born too small, but it did seem to make some babies born too early.
Methodology
A retrospective observational study comparing birth outcomes of infants exposed and unexposed to HAART.
Potential Biases
Potential bias from the selection strategy for the control group and differences in antenatal care received.
Limitations
Selection bias may have occurred as only women who consented were included, and the HAART-unexposed group may have had poorer health-seeking behaviors.
Participant Demographics
Mean age of participants was 30.1 years, with a median CD4 count of 159 cells/mm3.
Statistical Information
P-Value
p < 0.001
Confidence Interval
95% CI 0.45-0.71
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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