RESEARCH ARTICLE


Pregnancy Outcomes Among HIV-Infected Women Undergoing Antiretroviral Therapy



Darin Areechokchai1, Chureeratana Bowonwatanuwong2, Benjaluck Phonrat1, Punnee Pitisuttithum1, Wirach Maek-a-Nantawat1, *
1 Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
2 Chonburi Hospital, Chonburi, Thailand


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© Areechokchai et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Rd., Ratchathewi, Bangkok 10400, Thailand; Tel: 66-2643-5599; Fax: 66-2643-5598; E-mail: tmwmk@mahidol.ac.th


Abstract

Background

The use of antiretroviral drugs (ARV) to prevent mother-to-child HIV transmission (PMTCT) promises to be effective. However, limited data on the adverse effects of ARV among pregnant women and pregnancy outcomes have been reported in clinical practice.

Objectives

This study aimed to assess adverse effects and outcomes among pregnant HIV-infected women receiving antiretroviral drugs for either antiretroviral therapy (ART) or PMTCT.

Study Design

This cohort study was at Chonburi Hospital, Thailand, in 2002-2006.

Results

A total of 246 pregnant HIV-infected women with the median age (range) of 27 (16-41) years were included in this study. ART was initiated in 16.3% for treatment during ANC, 66.7% for PMTCT during ANC, and 17.1% for PMTCT in labor. Adverse effects, especially anemia, were significantly associated with continuing combined ART in pregnancy (p<0.001). 88.9% delivered normal-term neonates. The prevalence of pre-term delivery was 10.2%. Overall, 24 adverse events from 21 pregnant women (8.5%) were noted. A significantly higher prevalence of pre-term delivery was noted in the groups continuing combined ART, or initiating of PMTCT during labor rather than ANC (p=0.02). The incidence of low Apgar scores was 3.6%, and these were associated with initiation of PMTCT during labor (p=0.004).

Conclusion

Adverse ARV events were more numerous among the pregnant women who needed ART than PMTCT. ANC is beneficial and strongly recommended for all pregnant HIV-infected women for better pregnancy outcomes.

Keywords: HIV, Adverse effects, antiretroviral drugs, pregnancy, PMTCT..