Association Between HIV in Pregnancy andAntiretroviral Therapy, Including Protease Inhibitorsand Low Birth Weight Infants

[摘要] Objective:To determine the inciden’ce of low birth weight infants born to HIV seropositive womenand to demonstrate any effects of antiretroviral therapy on birth weight.Methods:Retrospective review of all obstetrical medical records from January 1, 1995 throughJune 30, 1998 to identify HIV seropositive women. We evaluated their antiretroviral therapy, CD4counts, and birth weights of their newborns. We conducted detailed review of the clinical andlaboratory findings for the HIV-infected untreated patients, women who received ZDV antepartumalone, and those who received PIs as part of antiretroviral treatment.Results:The frequency of low birth weight infants was significantly increased in HIV seropositivecompared to HIV seronegative parturients. Low birth weight infants were more frequentamong HIV infected women with lower CD4 counts but the association was not statisticallysignificant. Women who received no antepartum treatment, antepartum only ZDV, and thosetreated with PIs had significantly more low birth weight infants than did comparison groups. HIVseropositive women also had high frequencies of several obstetrical risk factors for low birth weightinfants.Conclusion:The present study showed a significantly increased frequency of low birth weightinfants among HIV infected women and especially the subgroups of infected women who receivedno antepartum treatment, antepartum ZDV only, and those treated with PIs. This association,however, may be related to the presence of many other preterm obstetrical risk factors noted in thisstudy. Increasing numbers of HIV seropositive women are being treated with PIs according to theCenters for Disease Control (CDC) guidelines. If PIs are a cause of low birth weight infants,women taking these drugs may have incremental risk of low birth weight. Infect. Dis. Obstet.Gynecol. 8:94–98; 2000.

[学科分类] 妇产科学