Antiretroviral Therapy Use During Pregnancy and the Risk of Small for Gestational Age Birth in a Medicaid Population.
Antiretroviral Therapy Use During Pregnancy and the Risk of Small for Gestational Age Birth in a Medicaid Population.
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DOI：
10.1097/inf.0000000000000712
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发表时间：
2015-07
期刊：
影响因子：
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通讯作者：
Hernandez-Diaz S
中科院分区：
文献类型：
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作者：
Phiri K;Williams PL;Dugan KB;Fischer MA;Cooper WO;Seage GR 3rd;Hernandez-Diaz S
Several studies have assessed the association between antiretroviral (ARV) therapy use during pregnancy and small for gestational age (SGA), but the evidence remains incompletely elucidated. We linked data from Tennessee Medicaid files and vital records to evaluate pregnancies among human immunodeficiency virus (HIV)-infected women who delivered between 1994 and 2009.Maternal HIV status was defined based on diagnosis codes, ARV prescriptions, and laboratory codes for CD4 count or HIV RNA assays. ARV use was identified from pharmacy claims. Risk of SGA (defined as birthweight below the 10th percentile for gestational age) and preterm birth were evaluated using logistic regression models. 477 HIV- infected pregnant women contributing 604 singleton pregnancies were identified; 156 (26%) delivered SGA infants. ARV use during pregnancy was not associated with SGA (adjusted odds ratio [aOR] = 0.93; 95% confidence interval [CI], 0.56-1.56) or preterm birth (aOR = 0.74; 95% CI, 0.42-1.32). Exposure to a protease inhibitor (PI) during the first trimester was associated with a lower risk of SGA (OR, 0.54; 95% CI, 0.29-1.01) compared to non-exposure to a PI throughout pregnancy. We observed no evidence of an association between ARV exposure during pregnancy and SGA delivery in this Medicaid cohort of HIV-infected women.
