Am J Perinatol 2008; 25(6): 335-339
DOI: 10.1055/s-2008-1078757
© Thieme Medical Publishers

Protease Inhibitor Therapy and Fetal Growth Potential in HIV-Positive Women

Sara Iqbal1 , Jan Kriebs1 , Christopher Harman1 , Sadettin Gungor1 , Lindsay Alger1 , Ozhan Turan1 , Jerome Kopelman1 , Andrew Malinow1 , Ahmet A. Baschat1
  • 1Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland, Baltimore, Maryland
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Publikationsdatum:
28. Mai 2008 (online)

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ABSTRACT

Our objective was to test if protease inhibitors (PIs) increase the incidence of fetal growth restriction (FGR). Human immunodeficiency (HIV)-seropositive women were studied. At birth the neonatal weight percentile was assigned by predicted growth potential (GP), accounting for race, parity, weight, height, gestational age, birthweight, and gender (Gardosi, 1992). FGR was defined as GP < 10% percentile. Maternal age, CD4 count, viral load, weight gain, prenatal care, tobacco, alcohol, substance abuse, and PI use were related to FGR using chi-square and multiple regression analysis. Ninety-three of 191 women received PI. In these, FGR occurred in 27 (29%) compared with 15 (15.3%) in the non-PI group (p = 0.02). Maternal CD4 count (p < 0.0001) was the primary determinant, and smoking (p = 0.037) was an independent cofactor for FGR (Nagelkerke r2 = 0.24). Twenty-six of 82 (31.7%) smokers had FGR, versus 16 of 109 (14.7%) of nonsmokers (odds ratio, 2.69; 95% confidence interval, 1.33 to 5.46; p = 0.005). After exclusion of the CD4 count, PI became a cofactor for FGR (p = 0.021 and Nagelkerke r2 = 0.104). We concluded that maternal HIV status and smoking determine the risk for FGR. Although PIs increase the risk for FGR, this effect appears to depend on maternal disease severity.

REFERENCES

Ahmet Alexander BaschatM.D. 

Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Maryland, Baltimore

405 West Redwood Street, 4th floor, Baltimore, MD 21201-1703