Effects of Antiretroviral Therapy and HIV Exposure in Utero on Adverse Pregnancy and Infant Outcomes:A Prospective Cohort Study in Guangzhou, China
- Author:
Fang HU
1
;
Jing Jing LIANG
;
Jun Jian LU
;
Fei Yi HU
;
Yan HU
;
Jia YU
;
Wen Xing ZOU
;
Hua Ying MA
;
Fang Sui LIN
Author Information
- Keywords: HIV; Adverse pregnancy outcome; Adverse infant outcome; Mother-to-child transmission(MTCT); Antiretroviral therapy (ART)
- From: Biomedical and Environmental Sciences 2019;32(10):719-729
- CountryChina
- Language:Chinese
- Abstract: Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou,China The women were assigned to receive combination ART (cART) or mono/dual ART or no treatment.The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy,spontaneous abortion,stillbirth,preterm birth,small for gestational age (SGA)] and adverse early growth outcome (including infant death,HIV infection of mother-to-child transmission,and underweight,wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202 (35.1％) of all enrolled HIV-infected women,and 121 (31.3％) of all infants exhibited adverse effects on early growth at 4 weeks of age.The rates of adverse pregnancy outcomes,spontaneous abortion,ectopic pregnancy,stillbirth,infant death and perinatal HIV infection were higher among women not receiving ART,compared to those treated with cART or mono/dual ART (P ＜ 0.05).However,women treated with cART had a higher rate of SGA,compared to untreated women (P ＜ 0.05).No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART,as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival
