Ramokolo V, et al. - In this work, researchers investigated the effect of infant in-utero HIV and antiretroviral therapy (ART) exposure on preterm delivery (PTD), low birth weight (LBW), small-for-gestational age (SGA) and underweight-for-age (UFA) at six-weeks. Improved birth outcomes were observed with ART, however, there appeared an association between pre-conception ART and PTD.

Methods

• 6179 HIV-unexposed-uninfected (HUU) and 2599 HIV-exposed-uninfected (HEU) infants were surveyed.
• Stratification of HEU infants into three groups was performed: ART; Zidovudine alone; no antiretrovirals (None).
• Researchers further stratified the ART group to explore pre- or post-conception exposure.
• Effects of HIV and ARV exposure on the outcomes were assessed with multivariable logistic regression.

Results

• Higher odds of PTD, LBW, SGA and UFA were observed in HEU than HUU infants.
• Researchers observed that HEU in the None group (adjusted odds ratio [AOR], 1.9; 95% CI, 1.2, 3.0) or those whose mothers initiated ART pre-conceptually (AOR, 1.7; 1.1, 2.5) had almost twice the odds of PTD than infants whose mothers started ART post-conceptually, but no increased odds for other outcomes.