The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy members are given in Appendix 1.
Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001–2011
Article first published online: 31 MAY 2013
© 2013 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 12, pages 1466–1476, November 2013
How to Cite
Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001–2011. BJOG 2013;120:1466–1476., , , , , , , , , , , , , , , .
- Issue published online: 11 OCT 2013
- Article first published online: 31 MAY 2013
- Manuscript Accepted: 29 JAN 2013
- Italian Medicines Agency. Grant Number: H85E08000200005
- Antiretroviral therapy;
- birth defects;
- HIV ;
- non-nucleoside reverse transcriptase inhibitors;
- nucleoside reverse transcriptase inhibitors;
- protease inhibitors;
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.
University and hospital clinics.
Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy.
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.
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%).
This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.