Adverse Pregnancy Outcomes Among Women Who Conceive on Antiretroviral Therapy.
Journal article
Authors / Editors
Research Areas
No matching items found.
Publication Details
Author list: Hoffman RM, Brummel SS, Britto P, Pilotto JH, Masheto G, Aurpibul L, Joao E, Purswani MU, Buschur S, Pierre MF, Coletti A, Chakhtoura N, Klingman KL, Currier JS, PROMISE (Promoting Maternal and Infant Safety Everywhere) 1077HS Team
Publication year: 2019
Journal acronym: Clin Infect Dis
Volume number: 68
Issue number: 2
Start page: 273
End page: 279
Number of pages: 7
ISSN: 1058-4838
eISSN: 1537-6591
Languages: English-Great Britain (EN-GB)
Abstract
Background\nMethods\nResults\nConclusions\nAdverse pregnancy outcomes for women who conceive on antiretroviral therapy (ART) may be increased, but data are conflicting.\nHuman immunodeficiency virus-infected, nonbreastfeeding women with pre-ART CD4 counts ≥400 cells/μL who started ART during pregnancy were randomized after delivery to continue ART (CTART) or discontinue ART (DCART). Women randomized to DCART were recommended to restart if a subsequent pregnancy occurred or for clinical indications. Using both intent-to-treat and as-treated approaches, we performed Fisher exact tests to compare subsequent pregnancy outcomes by randomized arm.\nSubsequent pregnancies occurred in 277 of 1652 (17%) women (CTART: 144/827; DCART: 133/825). A pregnancy outcome was recorded for 266 (96%) women with a median age of 27 years (interquartile range [IQR], 24-31 years) and median CD4+ T-cell count 638 cells/μL (IQR, 492-833 cells/μL). When spontaneous abortions and stillbirths were combined, there was a significant difference in events, with 33 of 140 (23.6%) in the CTART arm and 15 of 126 (11.9%) in the DCART arm (relative risk [RR], 2.0 [95% confidence interval {CI}, 1.1-3.5]; P = .02). In the as-treated analysis, the RR was reduced and no longer statistically significant (RR, 1.4 [95% CI, .8-2.4]).\nWomen randomized to continue ART who subsequently conceived were more likely to have spontaneous abortion or stillbirth, compared with women randomized to stop ART; however, the findings did not remain significant in the as-treated analysis. More data are needed on pregnancy outcomes among women conceiving on ART, particularly with newer regimens.
Keywords
No matching items found.
Documents
No matching items found.
